Do Seniors with Dementia Show Signs of Financial ‘Symptoms’ Years before a Diagnosis?

A study at Johns Hopkins University found that beneficiaries diagnosed with dementia who had a lower educational status missed payments on bills starting as early as seven years before a clinical diagnosis, as compared to 2½ years prior to a diagnosis for beneficiaries with higher educational status.

Medical Express’s recent article entitled “Older adults with dementia exhibit financial 'symptoms' up to six years before diagnosis” explains that the study included researchers from the University of Michigan Medical School. They found that the missed payments and other adverse financial outcomes lead to increased risk of developing subprime credit scores starting 2½ years before a dementia diagnosis (credit scores fall in the fair and lower range).

The findings, published online in JAMA Internal Medicine, say that financial symptoms, like missing payments on routine bills could be used as early predictors of dementia and emphasizes the benefits of earlier detection.

"Currently there are no effective treatments to delay or reverse symptoms of dementia," says lead author Lauren Hersch Nicholas, Ph.D., associate professor in the Department of Health Policy and Management at the Bloomberg School. "However, earlier screening and detection, combined with information about the risk of irreversible financial events, like foreclosure and repossession, are important to protect the financial well-being of the patient and their families."

The study found that the elevated risk of payment delinquency with dementia accounted for 5.2% of delinquencies among those six years prior to diagnosis—reaching a maximum of 17.9% nine months after diagnosis. The rates of elevated payment delinquency and subprime credit risk persisted for up to 3½ years after beneficiaries got a dementia diagnoses, suggesting an ongoing need for assistance managing money.

Dementia is a progressive brain disorder that slowly diminishes memory and cognitive skills and restricts the ability to carry out basic daily activities, such as managing personal finances. About 14.7% of American adults over the age of 70 are diagnosed with the disease. The onset of dementia can lead to costly financial errors, irregular bill payments and increased susceptibility to financial abuse.

For their study, the researchers compared financial outcomes from 1999 to 2018 of those with and without a clinical diagnosis of dementia for up to seven years prior to a diagnosis and four years following a diagnosis. They looked at missing payments for one or more credit accounts that were at least 30 days past due, and subprime credit scores, indicative of a person's risk of defaulting on loans based on credit history.

To determine whether the financial symptoms observed were unique to dementia, they also looked at the financial outcomes of missed payments and subprime credit scores to other health outcomes including arthritis, glaucoma, heart attacks and hip fractures. The team saw no association of increased missed payments or subprime credit scores prior to a diagnosis for arthritis, glaucoma, or a hip fracture. No long-term issues were linked to heart attacks.

"We don't see the same pattern with other health conditions," says Nicholas. "Dementia was the only medical condition where we saw consistent financial symptoms, especially the long period of deteriorating outcomes before clinical recognition. Our study is the first to provide large-scale quantitative evidence of the medical adage that the first place to look for dementia is in the checkbook."

Reference: Medical Express (Nov. 30, 2020) “Older adults with dementia exhibit financial 'symptoms' up to six years before diagnosis”