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 The first step to fixing this problem is giving it a name, according
to Dr. Mark Lachs of Weill Cornell Medical College in New York and
Duke Han of Rush University Medical Center in Chicago, coauthors of
the report, who want to describe the condition as “age-associated
financial vulnerability.”
“It is my hope that by coining this term – age-associated financial
vulnerability – it will begin to get physicians to think about this
in all older people with and without cognitive problems in the same
way they have begun to ask about advanced directives and driving
safety as people age,” Lachs said by email.
Writing in Annals of Internal Medicine, Lachs and Han define
age-associated financial vulnerability as a pattern of risky
behavior related to money that places an older adult at substantial
risk for a considerable loss of resources that might result in
dramatic changes in their quality of life and is inconsistent with
choices the person made when they were younger.
Doctors need to understand how the aging brain, with or without
neurological disease, influences financial decision-making, because
elderly patients may not have earned income or a long enough
investment horizon to recover from losses, Lachs said.
Financial exploitation is also the most common form of elder abuse,
accounting for about half of cases, and this in turn can lead to bad
health outcomes including depression, nursing home placement and
increased mortality, he added.
Factors that can contribute to financial vulnerability among the
elderly include cognitive or emotional decline; impairments in
vision, hearing or mobility; serious progressive illness; and social
isolation. Certain diseases and medications can also hasten
cognitive decline and make it harder for older adults to manage
their money.
While more research may be needed before doctors embrace
age-associated financial vulnerability as a medical term or as the
basis for a new clinical diagnosis, it remains important for doctors
to understand the connection between money mistakes and cognitive
decline, said Dr. Eric Widera, a geriatrics specialist at the
University of California, San Francisco.
When a person starts to make even minor financial missteps as they
age, this may be an indication of dementia, Widera, who wasn’t
involved in the article, said by email.
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“Financial impairment is often one of the earliest clinical signs of
emerging dementia, that often goes undiagnosed,” Widera said. “It
becomes exceedingly important that when these diagnoses are made,
and when individuals still have the ability to make decisions, to
think about things like advanced financial planning – assigning
someone such as a family member to make designated financial
decisions on their behalf.”
People can also take steps in middle age to improve their financial
literacy and keep an eye out for early indications that they need
help managing their money, noted Dr. Leslie Kernisan, a geriatrician
who blogs for families about money and other age-related problems at
GeriatricsForCaregivers.net.
Indications that older adults may be vulnerable financially include
taking longer to complete everyday financial tasks, reduced
attention to details in financial documents, decline in everyday
math skills, decreased understanding of financial concepts, and
difficulty identifying risks in financial opportunities, Kernisan,
who wasn’t involved in the article, said by email.
“In an ideal world, it would make sense to assess for financial
vulnerability as part of a regular comprehensive assessment for
common age-related problems – falls, mobility issues, difficulty
managing activities of daily living, isolation, cognitive changes –
that often affect the health and life of seniors,” Kernisan said.
SOURCE: http://bit.ly/1i46lF7 Annals of Internal Medicine, online
October 12, 2015.
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