Low scam awareness in old age may be an early sign of impending cognitive decline and dementia

Low scam awareness in older people is associated with risk for developing Alzheimer dementia or mild cognitive impairment in the future. These findings suggest that changes in social judgment occur before changes in thinking or memory are recognizable. Findings from a prospective cohort study are published in Annals of Internal Medicine.

Identifying predictors of dementia and mild cognitive impairment is critically important, but which aspects of behavior to target remains unclear. Older adults frequently are targeted by con-artists and are highly vulnerable to scams and fraud, particularly those that are financial in nature. However, little is known about whether scam awareness predicts transitions from normality to mild cognitive impairment and dementia.

Researchers from Rush Alzheimer’s Disease Center in Chicago asked 935 older persons to complete a “scam awareness questionnaire” when all were free from dementia to ascertain a scam awareness score. Over an average of 6 years of follow up, participants also completed traditional neuropsychological tests every year, and the 264 participants who died had an autopsy of the brain to look for the hallmarks of Alzheimer disease. The researchers found that low scam awareness was a harbinger of adverse cognitive outcomes. Low scam awareness was also associated with Alzheimer disease pathology in the brain. According to the researchers, these findings suggest that low scam awareness is an early sign of impending mild cognitive impairment and dementia. Further, they conclude that evaluation of behaviors such as scam awareness may help to identify individuals at risk for dementia before cognitive symptoms manifest.

According to the author of an accompanying editorial, this study provides new information about social cognition as it relates to aging. The author provides an example of a patient who was scammed out of the majority of his life savings by a slick fraudster who tricked him into thinking he had won the lottery. Diminished financial capacity, financial abuse, and exploitation are major economic and public health problems. An older adult who is defrauded may end up unable to pay for medications, food, and long-term care, the author wrote. As such, the findings from this study should be a call to action for health care systems, the financial services industry, and their regulators to protect the health and wealth of our aging population.

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