Mild Cognitive Decline Is a Risk Factor for Scam Vulnerability in Older Adults

Research on elderly financial exploitation has mostly focused on financial abuse that occurs in families and other types of trusted relationships. As such, little is known about financial frauds and scams perpetrated by strangers. Financial fraud and scam prevention activities for older adults must be promoted, for which the correlation between the psychological, social, and cognitive characteristics of their vulnerability needs to be determined. The present study aimed to determine whether cognitive decline is a risk factor for scam vulnerability in older adults. Thus, we created a scam vulnerability scale for older adults with cognitive decline and analyzed the data to reveal the correlation between them, including inhibition and executive function. We conducted an interview survey with 50 older adults with cognitive decline (average age: 79.42 years, SD: 5.44) and 51 older adults without cognitive decline (average age: 76.12 years, SD: 5.82). The interview survey included the scam vulnerability scale, psychosocial questionnaires, and neuropsychological tests. The scale included six items with a four-point Likert scale based on a previous study. Hierarchical multiple regression analysis revealed that lower scores on the Japanese version of the Alzheimer's Disease Assessment Scale–Cognitive Subscale (ADAS-Jcog; indicating higher general cognitive function) correlated with higher scam vulnerability in the cognitive decline group (β = −0.46, p < 0.001). In addition, men were found to be more vulnerable in both groups (cognitive decline group: β = −0.29, p = 0.015, cognitive non-decline group; β = −0.32, p = 0.018). Inhibition and executive function were found not to correlate significantly with scam vulnerability. These results suggest that mild cognitive decline correlates with higher scam vulnerability, whereas moderate to severe cognitive decline correlates with lower vulnerability, possibly because it makes understanding the scam attempt itself difficult. Older adults with mild cognitive decline and their families, particularly those visiting elderly care or outpatient facilities, should be notified of the scam vulnerability of older clients using the ADAS-Jcog score as an index to help them avoid victimization.

A Family Systems Perspective of Elder Family Financial Exploitation: Examining Family Context Profiles

Objective: Informed by Family Systems Theory, this study examines the interwoven nature of intergenerational family structures and roles in which elder family financial exploitation (EFFE) takes place. Method: Data from a mixed-methods study were utilized to examine patterns of family structures and roles within and across 23 family systems. Participants were non-perpetrator/non-victim concerned family members (CFMs) who had experienced EFFE. Results: Four family context profiles were identified, organized by the number and roles of victim(s) and perpetrator(s) in each family system, including: Single victim, Single perpetrator; Single victim, Multiple perpetrators; Two victims, Single perpetrator; and Two victims, Multiple perpetrators. It is possible for multiple perpetrators to be involved, with up to five perpetrators across three generations in our sample. Discussion: Findings offer insight into the range of intergenerational family structures and roles affected by EFFE. Practitioners are encouraged to understand and address family contexts to improve EFFE intervention outcomes.

Face-Saving and Help-Seeking Among U.S. Chinese Older Adults With Elder Mistreatment

Chinese culture places a high value on saving face and not bringing shame to the family. This study aimed to examine the associations between face-saving and help-seeking among U.S. Chinese older adults who experienced elder mistreatment (EM). Data were retrieved from the PINE study. Regression analyses were performed. Most EM victims sought help from informal sources only (48.21%), followed by no help (26.79%), informal plus formal help (19.64%), and formal help only (5.36%). For EM screening, face-saving was associated with informal help-seeking intentions (p < .05). For EM subtypes, face-saving was associated with overall help-seeking intentions for financial exploitation (p < .05), but not on physical mistreatment, psychological mistreatment, and caregiver neglect. Face-saving was not associated with help-seeking behaviors. Study findings underscore the significance of a unique cultural value in understanding EM help-seeking intentions among Chinese older adults. Cultural constructs should be considered in future EM research in diverse populations.

Characteristics of Financial Exploitation in a Sample of Israeli Older Adults

Financial exploitation (FE) negatively affects wellbeing in older adulthood. However, characteristics of FE and its health correlates remain poorly understood. In this study, 138 Israeli older adults answered questions regarding FE history, and completed physical and mental health questionnaires. Of 138 participants, 23 reported a history of FE. FE participants were older (M birth year = 1950.35; sd = 9.65) than non-FE participants (M birth year = 1953.79; sd = 6.06; p = 0.028) and reported lower household income (p=0.001). Groups did not differ in education level or sex breakdown. The FE group reported older subjective age (p = 0.022), worse subjective cognition (p = 0.007), more depressive symptoms (p=0.002), and marginally higher anxiety symptoms (p = 0.099) than the non-FE group. Groups did not differ in reported levels of social support or number of medical conditions. When covarying for age, differences between groups in subjective cognition and depressive symptoms remained significant (ps ≤0.022), while subjective age differences became marginal (p = 0.07). The FE group responded to follow-up questions regarding FE experiences. Reported perpetrators included companies/businesses (most commonly reported, 30%), strangers, friends/neighbors, service providers, and family. Eleven reported losing 100 NIS to 10,000 NIS, and 10 reported losing 10,001 to over 100,000 NIS. Additionally, six FE participants reported that the FE is ongoing, and two reported additional FE experiences. Findings suggest that FE is related to mental and physical health of older adults. Findings also provide preliminary information regarding characteristics of FE in a sample of Israeli older adults.

Indicators of Elder Mistreatment: Correlates among Veterans Receiving Care in the Veterans Health Administration

Among community-dwelling adults ages 65 and older, approximately 11% have experienced elder mistreatment (EM), including physical, emotional or sexual abuse, neglect, or financial exploitation. EM research typically focuses on this age group; however, Veterans receiving Veterans Health Administration (VHA) care have increased earlier morbidity, which may accelerate the impacts of EM. Using a cohort of all VHA Veterans 50 years and older with VHA use in 2018-2020, we examined correlates of EM. ICD-10 codes from clinical encounters identified Veterans with indications of EM (n=4,427). A 10% sample of Veterans without indications of EM was selected for comparison (n=530,535). Logistic regression compared EM+ Veterans to the comparison sample and assessed overall demographic and clinical differences as well as differences by age, i.e. 50-64 versus 65 and older. Overall, female gender (OR=5.3, 95% CI=4.3-6.5), non-white race/ethnicity (OR=1.7, CI=1.5-1.9), dementia (OR=3.0, CI=2.6-3.5), PTSD (OR=2.0, CI=1.6-2.5), anxiety (OR=1.3, CI=1.0-1.5), military service connected disability status (OR=1.3, CI=1.1-1.5), and higher Elixhauser medical morbidity scores (OR=1.1, CI=1.1-1.1) were associated with EM. Prior year ER visits (OR=28.0, CI=23.6-33.4), inpatient stays (OR=14.0, CI=11.5-17.0), and mental health visits (OR=26.1, CI=22.2-30.6) also predicted EM+ status. Forty-six percent of VHA Veterans with indicators of EM were aged 50-64. For these Veterans, female gender, PTSD, service connection, and mental health visits were associated with increased risk of EM compared to Veterans 65+. Findings highlight clinical correlates of EMs among Veterans in VHA care. Increased awareness of EM risk factors is warranted and may inform VHA efforts for EM prevention, detection and intervention.

Polyvictimization and Cognitive Function in an Ethnic Minority Aging Population

Globally, around 1 in 6 older adults experienced some form of elder mistreatment in community settings. However, little is known about the prevalence of polyvictimization, or experience of multiple forms of abuse, which may exacerbate negative outcomes over that of any one form of victimization in isolation. Data were drawn from the PINE study. Polyvictimization was defined as exposure to multiple forms of victimization, including psychological, physical, and sexual mistreatment, financial exploitation, and caregiver neglect. Cognitive function was evaluated by global cognition, episodic memory, executive function, working memory, and MMSE. Regression analyses were performed. Among 3153 participants, 128 experienced two forms of abuse while 12 experienced three or more forms of abuse. Polyvictimization was associated with lower global cognition (b=-0.05, SE=0.02, p<.05), episodic memory (b=-0.06, SE=0.03, p<.05), working memory (b=-0.14, SE=0.07, p<.05), and processing speed (b=-0.68, SE=0.33, p<.05). Interventions could target older adults with polyvictimization and protect their cognitive function.

Financial Exploitation of Older Adults During the Early Months of the COVID-19 Pandemic

COVID-19 created a “perfect storm” for financial exploitation directed at older adults. We invited adults aged 60 and older enrolled in gerontology research registries at Virginia Tech, Florida State University, Wayne State University, and University of Pittsburgh to complete an on-line survey about experiences with financial exploitation by strangers. The 997 respondents ranged in age from 60 to 98 (M = 71.3; SD = 6.8); most identified as White (93.4%), female (64.2%) and living with a spouse/partner (58%). Approximately one-half of respondents (56.87%) reported experiencing a scam attempt about COVID-19 issues. Most contact by scammers was electronic (49%) and frequently occurred two or more times (40%). Most respondents ignored the request (i.e., hung up phone, deleted text/email, threw away mail). However, 9% sent the requested payment, and 4% gave the scammer their personal information. Confidence in financial matters and having attended financial educational programs protected older adults from being scammed.

Elder family financial exploitation: Family relationships are never the same

Millions of families are affected by elder family financial exploitation (EFFE), but the consequences for lifelong intergenerational family relationships and family functioning remain largely unexamined (i.e., parent/child, siblings). This study examines the consequences of experiencing EFFE on the quality of family relationships from the perspective of non-victim, non-perpetrator concerned family members (CFMs). Data from a larger EFFE mixed-methods study were utilized. A voluntary sample of 28 CFMs who had experienced EFFE participated in semi-structured, in-depth interviews and brief surveys. Analysis included identifying quality of family relationship themes from data related to differences EFFE has made in their family. Participating CFMs were primarily adult children of older victims, and siblings of the primary perpetrators. The findings reflect three patterns of changes in quality of family relationships between the CFMs and other family members, including: (a) Restoring trust and recovery within the family, (b) Alliances and taking sides, and (c) Estrangement and cutoff. While families were never the same after experiencing the exploitation, for some was a healing process to accept the family situation and restore and repair trust. Redefining who would be family moving forward was a focus for some families when perpetrators and CFMs took sides and formed allies with others. In the most dramatic changes, siblings, parents and others became cutoff and isolated from other family members. While a loss of relationship quality was common, strengthening of relationships also occurred. Understanding EFFE from an ecological family systems perspective can help to inform needed EFFE interventions, both processes and outcomes.

Perceived Financial Vulnerability Is Related to Perceived Cognitive Impairment and Living Alone

Objective Perceived financial vulnerability is linked to physical and mental health and also to risk for financial exploitation (Lichtenberg et al., 2020a,b). This study examined the relationship of risk scores for financial exploitation to demographic variables, perceived memory loss and living alone. Methods The 17-item self-report Financial Exploitation Vulnerability Scale (FEVS) posted on our website https://olderadultnestegg.com was completed by a convenience sample of 258 older adults. Correlational, multiple regression and Chi Square analyses were used. Results Thirty percent of the sample scored at an elevated risk for financial exploitation due to perceived financial vulnerability. Although this was a convenience sample the results were similar to what was found in a sub-study of the HRS. Thirty eight percent of participants were living alone and 38% reported that their memory was less reliable than a year ago. Financial vulnerability risk score was significantly related to decreased education (r=-.12), living alone (r=.21) and perceived memory loss (r=.35). Eighteen percent of the variance was accounted for in a multiple regression (F(5,250)=10.73, p<0.001, r2=0.18) with all three measures predicting FEVS risk score independently. The combination of perceived memory loss and living alone was significantly associated with the highest percentage of elevated risk scores. Discussion Perceived financial vulnerability and its relationship to health (e.g. memory loss) and financial exploitation, continues to be under-appreciated in gerontology and geriatrics research. Our findings, consistent with GSA's Longevity Fitness report further highlights this important dimension.

A Scoping Review of Financial Elder Exploitation Interventions

Elder financial exploitation (EFE), defined by the National Center for Elder Abuse (2021) as “the misappropriation of an older person’s money or property,” is a continuing public health crisis shown to cost individuals at least $2.9 billion a year (MetLife Mature Market Institute, 2011). Many believe this impact will increase exponentially due to the effects of COVID-19. In fact, a recent study conducted by Chang & Levy (2021) found that the prevalence of elder abuse as a whole increased from 1 in 10 older adults to 1 in 5 in the past year. Although increased collaboration between state attorneys general, Adult Protective Services, and financial institutions has driven progress in the field; there is still little known regarding EFE interventions. To address this issue, this study conducts a scoping review of the EFE intervention literature. This approach was chosen over a systematic review primarily due to the lack of a universal definition of EFE, as well as the limited number of studies available delineating between EFE and elder abuse as a whole. The main findings of the review reveal that current EFE intervention practices are focused on preventing abuse before it occurs by addressing risk factors for abuse in older adults; and are largely reliant on Adult Protective Services and the legal system. This finding is significant because state policies differ in their qualifications of EFE, thus leaving many older adults vulnerable and unprotected. Further interventions that address EFE while it is occurring and alignment across governing bodies are needed.