Scam Susceptibility May Be Early Sign of Dementia

Decreased scam awareness among older adults may be a warning sign of future cognitive decline or dementia, and an inability to detect scams also is associated with the development of Alzheimer disease changes in the brain, according to researchers with the Rush Alzheimer’s Disease Center. The team reported its findings in an article published recently in the Annals of Internal Medicine.

Before people exhibit the loss of memory and reasoning ability that are widely recognized symptoms of Alzheimer’s disease, they often experience subtler changes in behavior. The Rush researchers’ findings suggest that changes in social judgement — including the ability to detect deceit — may be among the earliest manifestations of impending dementia.

“Decreased scam awareness may be a very early sign of Alzheimer’s disease — one that emerges well before cognitive symptoms are recognizable,” said Patricia Boyle, PhD, lead author of the study and professor at the Rush Alzheimer’s Disease Center. “Assessment of scam susceptibility may help identify individuals at greatest risk of developing cognitive impairment and who may benefit most from therapeutic intervention.”

At the beginning of the study, the researchers used a questionnaire to assess scam awareness among 935 older people who were free from dementia at the time. The exam included five questions about behavior related to susceptibility, including willingness to listen to sales pitches and consider risky investments, and the ability to recognize vulnerability to fraud due to older age.

Over an average of six years afterwards, the people in the study took annual neuropsychological tests that assessed their cognitive function. By the end of the study, 152 of them had developed Alzheimer’s dementia, and another 255 had mild cognitive impairment — a loss of cognitive abilities beyond what normally occurs with aging.

The study participants were mainly in their 70s and 80s and already were taking part in the Rush Memory and Aging Project, which is based out of the Rush Alzheimer’s Disease Center. They agreed to donate their brains for research after their deaths.

The researchers found that people who had low scam awareness at the start of the study had twice the risk of developing Alzheimer’s dementia and mild cognitive impairment compared to those with high scam awareness. The researchers also performed autopsies of the 264 participants who died during the study to look for the brain changes that accompany Alzheimer’s disease and found that low scam awareness was associated with more of these changes.

“Elder fraud poses a major public health and economic challenge,” Boyle said. “Scam susceptibility and changes in financial decision making may be red flags that someone needs assistance, and family members and care providers should be aware of these warning signs.”