2 Money Woes That Can Signal the Start of Dementia

Money management mistakes are part of life. Any of us can forget to pay a bill from time to time.

But a history of such behavior might hint at a deeper problem, according to recent research published online in the medical journal JAMA Internal Medicine.

People who eventually are diagnosed with Alzheimer’s disease or related dementia may have trouble managing their money several years before doctors make that diagnosis, according to researchers at two universities and the Federal Reserve Board of Governors.

In particular, such patients are:

• More likely to miss credit card payments as early as six years before a dementia diagnosis (when compared with study participants who were not diagnosed with dementia)
• More likely to have subprime credit scores — meaning scores in the “fair” range or lower — as early as 30 months prior to diagnosis

As part of the study, researchers looked at de-identified Medicare claims and credit report data for more than 81,000 people on Medicare, the federal health insurance program for seniors and people with certain disabilities and illnesses. The data came from the years 1999 to 2018.

All study participants were at least 65 and lived alone. About one-third were diagnosed with dementia during the period.

The researchers also looked for a correlation between missed payments and subprime credit scores and other health problems — including arthritis, glaucoma, heart attacks and hip fractures. They found no long-term associations.

Lead author Lauren Hersch Nicholas, a health economist at the Johns Hopkins Bloomberg School of Public Health, said in an announcement:

“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.”

Interestingly, the researchers found that people with lower education levels saw the number of missed payments rise as early as seven years before diagnosis. By contrast, people with higher education levels saw missed payments increase just 2½ years before diagnosis.

The researchers note that this difference adds weight to the findings of earlier studies that more-educated people can have dementia symptoms that are less severe.

The study’s findings have important implications for how people manage their money later in life. According to the National Institute on Aging, which partly funded the research:

“The study’s results help show that the period during which an older adult might be at risk of financial mismanagement and scams may be longer than currently understood and point to the need for early diagnostic tools and policies to help protect older adults.”

For more on dementia — and how to avoid it — read “7 Lifestyle Changes That May Help Prevent Dementia.”