1
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Weissberger GH, Lim AC, Mosqueda L, Nguyen AL, Fenton L, Han SD. Subjective Age Moderates the Relationship Between Global Cognition and Susceptibility to Scams. J Appl Gerontol 2024:7334648241229879. [PMID: 38323997 DOI: 10.1177/07334648241229879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
This study examined the interactive effect of subjective age on the relationship between global cognition and susceptibility to scams. Sixty-five participants underwent an assessment of global cognition (Mini Mental State Examination; MMSE), reported their perceived age (i.e., subjective age), and responded to a self-report questionnaire assessing scam susceptibility. A main effect of global cognition on scam susceptibility was found (p = .028); there was no main effect of subjective age (p = .819). An interaction between global cognition and subjective age was found (p = .016). Examination of conditional effects demonstrated that the relationship between cognition and scam susceptibility was not significant amongst those with subjective ages below one standard deviation of the mean, but was significant for those whose subjective ages fell around or above the mean. Findings suggest that individuals with older subjective ages may be particularly vulnerable to the negative effects of lower cognition on scam susceptibility.
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Affiliation(s)
| | - Aaron C Lim
- USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA
| | - Laura Mosqueda
- Keck School of Medicine of the University of Southern California, Alhambra, CA, USA
- USC Leonard Davis School of Gerontology, Los Angeles, CA, USA
| | | | - Laura Fenton
- USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA
| | - S Duke Han
- USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA
- Keck School of Medicine of the University of Southern California, Alhambra, CA, USA
- USC Leonard Davis School of Gerontology, Los Angeles, CA, USA
- Rush University Medical Center, Chicago, IL, USA
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2
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Getz SJ, Levin BE, Galvin JE. The Assessment of Situational Judgement Questionnaire: A Novel Instrument to Detect Susceptibility to Financial Scamming. J Alzheimers Dis 2024; 97:1365-1379. [PMID: 38250778 DOI: 10.3233/jad-231194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
BACKGROUND Existing measures of scam susceptibility lack ecological validity and situational variability. Evidence suggests that all adults may be susceptible to scams, though a comprehensive fraud victimization theory remains to be explored. OBJECTIVE To identify cognitive and sociodemographic variables that differentiate individuals with high scam susceptibility from those less susceptible. This article describes the development and feasibility of the Assessment of Situational Judgment questionnaire (ASJ), a brief tool designed to detect scam susceptibility. METHODS The 17-item ASJ was developed using a combination of existing scams reported by the Florida Division of Consumer Services and legitimate scenarios. Participants were presented with scam and legitimate scenarios and queried regarding their willingness to engage. Response options were offered with instructions on a 7-point Likert scale (extremely unlikely to extremely likely). Pilot data from a development sample provided the foundation for the final version of the ASJ. RESULTS The final version of the ASJ was administered to 183 online participants. The Scam factor (8 items) explained 50.6% of the variance. The Legit factor (9 items) reported on a 7-point Likert scale explaining 10.6% of the variance. A Scam to Legit ratio provides a proxy for overall scam susceptibility. Cut-off scores of 24 on the Scam factor, 47 on the Legit factor, and 0.62 on the ratio optimize measures of scam susceptibility. CONCLUSIONS The ASJ is a brief, ecologically valid measure of scam susceptibility. There is a need for a sensitive and specific tool to detect scam susceptibility in clinical, community, and financial settings.
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Affiliation(s)
- Sarah J Getz
- Comprehensive Center for Brain Health, University of Miami, Miller School of Medicine, Boca Raton, FL, USA
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Bonnie E Levin
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, University of Miami, Miller School of Medicine, Boca Raton, FL, USA
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL, USA
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3
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Wei W, Balser S. A Systematic Review: Risk and Protective Factors of Elder Abuse for Community-Dwelling Racial Minorities. TRAUMA, VIOLENCE & ABUSE 2024; 25:73-86. [PMID: 36541634 DOI: 10.1177/15248380221140123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Elder abuse is related to numerous adverse health and mental health conditions in older adults and some studies indicated higher rates of elder abuse in ethnic and racial minority populations than non-Hispanic Whites. This current study aims to summarize the risk and protective factors associated with elder abuse in community-dwelling racial minorities. A systematic review was conducted following Preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. AgeLine, Medline, PsycINFO, and CINAHL were searched without limitation on time periods of publication. Two authors independently screened the search results and assessed the eligibility and quality of the retrieved articles. A total of 718 articles were screened and 25 articles were included in the review. The 25 included studies' publication dates range from 1989 to 2019. Five racial categories were generated: African Americans, Asian Americans, Native Americans, Hispanic Americans, and racial minorities in Canada. Risk and protective factors of elder abuse and its subtypes (e.g., physical and psychological abuse) for these racial groups were summarized. There are some common risk factors across racial minorities, such as dependence on caregivers and health issues. The review identified gaps and conflicting findings regarding culture and education that are worthy of further investigation. In particular, there is a lack of current research on elder abuse in racial minority older women, race minority subgroups, and protective factors of elder abuse. The results guide helping professionals to consider the role of traditional culture and identify warning signs of potential abuse among racial minority older adults.
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Affiliation(s)
- Wenxing Wei
- Case Western Reserve University, Cleveland, OH, USA
| | - Sarah Balser
- Case Western Reserve University, Cleveland, OH, USA
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4
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Hall L, Moray J, Gross E, Lichtenberg PA. The Relationship Between Financial Decision-Making and Financial Exploitation in Older Black Adults. J Aging Health 2022; 34:472-481. [PMID: 35418261 PMCID: PMC9133059 DOI: 10.1177/08982643221085407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: This study examined the relationship between contextual measure of financial decision-making and the financial exploitation experiences of older Blacks, and the convergent validity of mental health measures of contextual decision-making items. Methods: This cross-sectional study of 104 older Black adults included 52 cases of confirmed financial exploitation. Participants were matched on age and gender. Bivariate and multivariate analyses were performed to examine these relationships. Results: The contextual measure of financial decision-making was significantly associated with financial exploitation, above and beyond the relationship of demographic measures. Further, there was strong evidence for convergent validity between the contextual measure and mental health measures. Discussion: Results underscore the significant relationship of the contextual factors involved in financial decision-making and financial exploitation. This study provides a conceptually driven approach to understanding the experiences of older Black adult victims of financial exploitation.
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Affiliation(s)
- LaToya Hall
- Institute of Gerontology, Wayne State University, 87 E. Ferry Street, Detroit, MI 48202
| | - Juno Moray
- Institute of Gerontology and Department of Psychology, Wayne State University, 87 E. Ferry Street, Detroit, MI 48202
| | - Evan Gross
- Institute of Gerontology and Department of Psychology, Wayne State University, 87 E. Ferry Street, Detroit, MI 48202
| | - Peter A Lichtenberg
- Institute of Gerontology, Wayne State University, 87 E. Ferry Street, Detroit, MI 48202
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5
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Sunderaraman P, Gazes Y, Ortiz G, Langfield C, Mensing A, Chapman S, Joyce JL, Brickman AM, Stern Y, Cosentino S. Financial decision-making and self-awareness for financial decision-making is associated with white matter integrity in older adults. Hum Brain Mapp 2022; 43:1630-1639. [PMID: 34984770 PMCID: PMC8886641 DOI: 10.1002/hbm.25747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/28/2021] [Accepted: 11/14/2021] [Indexed: 11/11/2022] Open
Abstract
Financial decision-making (FDM) and awareness of the integrity of one's FDM abilities (or financial awareness) are both critical for preventing financial mistakes. We examined the white matter correlates of these constructs and hypothesized that the tracts connecting the temporal-frontal regions would be most strongly correlated with both FDM and financial awareness. Overall, 49 healthy older adults were included in the FDM analysis and 44 in the financial awareness analyses. The Objective Financial Competency Assessment Inventory was used to measure FDM. Financial awareness was measured by integrating metacognitive ratings into this inventory and was calculated as the degree of overconfidence or underconfidence. Diffusion tensor imaging data were processed with Tracts Constrained by Underlying Anatomy distributed as part of the FreeSurfer analytic suite, which produced average measures of fractional anisotropy and mean diffusivity in 18 white matter tracts along with the overall tract average. As expected, FDM showed the strongest negative associations with average mean diffusivity measure of the superior longitudinal fasciculus -temporal (SLFT; r = -.360, p = .011) and -parietal (r = -.351, p = .014) tracts. After adjusting for FDM, only the association between financial awareness and average mean diffusivity measure of the right SLFT (r = .310, p = .046) was significant. Overlapping white matter tracts were involved in both FDM and financial awareness. More importantly, these preliminary findings reinforce emerging literature on a unique role of right hemisphere temporal connections in supporting financial awareness.
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Affiliation(s)
- Preeti Sunderaraman
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,Gertrude. H. Sergievsky Center, Columbia University Irving Medical Center, New York, New York, USA.,Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Yunglin Gazes
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,Gertrude. H. Sergievsky Center, Columbia University Irving Medical Center, New York, New York, USA.,Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Gema Ortiz
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,Gertrude. H. Sergievsky Center, Columbia University Irving Medical Center, New York, New York, USA
| | - Christopher Langfield
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,Gertrude. H. Sergievsky Center, Columbia University Irving Medical Center, New York, New York, USA
| | - Ashley Mensing
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,Gertrude. H. Sergievsky Center, Columbia University Irving Medical Center, New York, New York, USA
| | - Silvia Chapman
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,Gertrude. H. Sergievsky Center, Columbia University Irving Medical Center, New York, New York, USA
| | - Jillian L Joyce
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,Gertrude. H. Sergievsky Center, Columbia University Irving Medical Center, New York, New York, USA
| | - Adam M Brickman
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,Gertrude. H. Sergievsky Center, Columbia University Irving Medical Center, New York, New York, USA.,Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Yaakov Stern
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,Gertrude. H. Sergievsky Center, Columbia University Irving Medical Center, New York, New York, USA.,Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Stephanie Cosentino
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,Gertrude. H. Sergievsky Center, Columbia University Irving Medical Center, New York, New York, USA.,Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
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6
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Hall L, Campbell R, Gross E, Lichtenberg PA. The Impact of Financial Coaching on Older Adult Victims of Financial Exploitation: A Quasi-Experimental Research Study. FINANCIAL COUNSELING AND PLANNING : THE JOURNAL OF THE ASSOCIATION FOR FINANCIAL COUNSELING AND PLANNING EDUCATION 2022; 33:66-78. [PMID: 35655948 PMCID: PMC9159538 DOI: 10.1891/jfcp-20-00047] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The financial exploitation (FE) of older adults affects not only victims' finances, but also their health. This preliminary study investigated the impacts of a financial coaching program on the financial, neurocognitive, physical, and emotional health of older adult victims of FE. Twenty older adults residing in a large urban area who had experienced FE were compared at baseline and follow-up with a group of 20 older adult of the same area who were making important financial decisions, but had not experienced FE and did not receive the intervention. At baseline, both groups were similar on demographic variables, but participants who had experienced FE had more health problems, poorer memory and executive functioning, less social support, and greater stress than the comparison group. Six months after financial coaching ended, program participants had significantly less anxiety. Overall, older adult victims of FE showed no significant declines and, in fact, showed some improvement.
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Affiliation(s)
| | - Rebecca Campbell
- Institute of Gerontology and Department of Psychology, Wayne State University, 87 E. Ferry Street, Detroit, MI 48202
| | - Evan Gross
- Institute of Gerontology and Department of Psychology, Wayne State University, 87 E. Ferry Street, Detroit, MI 48202
| | - Peter A Lichtenberg
- Institute of Gerontology and Merrill Palmer Skillman Institute, WSU Distinguished Service Professor Institute of Gerontology, Wayne State University, 87 E. Ferry Street, Detroit, MI 48202
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7
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Sun W, Matsuoka T, Narumoto J. Decision-Making Support for People With Alzheimer's Disease: A Narrative Review. Front Psychol 2021; 12:750803. [PMID: 34867639 PMCID: PMC8633444 DOI: 10.3389/fpsyg.2021.750803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 10/25/2021] [Indexed: 01/01/2023] Open
Abstract
The proportion of people with dementia has been increasing yearly, and the decision-making capacity of these people has become a major concern in fields such as the financial industry and in medical settings. In this narrative review, we discuss decision-making in people with Alzheimer’s disease (AD), and we propose the support for decision-making in people with AD, especially financial and medical decision-making. We summarize several hypotheses and theories on the decision-making capacity of people with AD. These include the frontal lobe hypothesis, physiological theory, dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, and the Person-Task-Fit (PTF) framework. Both internal and external factors can affect decision-making by people with AD. Internal factors are affected by changes in the brain and neurotransmitters, as well as alterations in cognitive ability and emotion. External factors include task characters, task contents, and situation influence. Since feedback has a significant effect on decision-making capacity, a series of suggestions may be helpful to improve this capacity, such as explicit advice, simple options, pleasant rewards, the Talking Mats approach, memory and organizational aid, support by caregivers, cognitive training and feedback. Thus, in providing decision-making support for people with AD, it is important to identify the internal and external factors that impair this process and to deal with these factors.
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Affiliation(s)
- Weiyi Sun
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Teruyuki Matsuoka
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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8
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Lichtenberg PA, Tocco M, Moray J, Hall L. Examining the Validity of the Financial Exploitation Vulnerability Scale. Clin Gerontol 2021; 44:585-593. [PMID: 34346285 PMCID: PMC8490314 DOI: 10.1080/07317115.2021.1954124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objectives: Objectives: Lichtenberg, Campbell, Hall, and Gross used a contextual framework for financial decision-making to create and provide evidence for a new scale to assess risk for financial exploitation, the Financial Exploitation Vulnerability Scale (FEVS). This study examined the criterion validity of self-reported memory complaints and living alone on FEVS risk scores.Methods: Participants were the first 258 individuals reporting as 60 years or older and who completed the FEVS on the https://olderadultnestegg.com website between December 2020 and February 2021. Correlations, multiple regression, analysis of variance, and chi-square analyses were conducted to compare groups based on risk scores.Results: FEVS risk scores were significantly correlated with years of education, self-reported memory complaints, and living alone; 18% of unique variance was accounted for by these measures in a regression analysis. The ANOVA indicated that while there was an interaction effect for memory complaints by living alone, the majority of variance accounted for was attributed to the self-reported memory complaints measure. Conclusions: Older adults with memory complaints are in need of perceived financial vulnerability assessment.Clinical Implications: The Financial Exploitation Vulnerability Scale is a valuable self-report tool that clinical gerontologists can use in their intake assessments and follow-ups.
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Affiliation(s)
| | - Maggie Tocco
- Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
| | - Juno Moray
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Latoya Hall
- Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
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9
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Campbell RJ, Lichtenberg PA. A Short Form of the Financial Exploitation Vulnerability Scale. Clin Gerontol 2021; 44:594-603. [PMID: 33124959 DOI: 10.1080/07317115.2020.1836108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The purpose of the present study was to develop a short form of the Financial Exploitation Vulnerability Scale (FEVS) with good psychometric properties to detect contextual risk exploitation. METHODS The sample included community volunteers who were 60 years and older, as well as elders who were referred to the SAFE program after being the victim of a financial scam or identity theft. All participants completed the FEVS as part of a larger test battery. Factors analysis was used to explore the underlying structure of the FEVS and eliminate items. ROC analysis and logistic regression were used to evaluate the clinical utility of the Financial Exploitation Vulnerability Scale - Short Form (FEVS-SF) to detect exploitation. RESULTS The resulting FEVS-SF was unidimensional, contained nine items, and had comparable internal consistency to the full FEVS. Sensitivity and specificity were good at a cut score of five or greater. FEVS-SF was a better predictor of exploitation than demographic factors and several measures of cognitive functioning. CONCLUSIONS The FEVS-SF can detect the experience of financial exploitation among older adults better than other known risk factors, and equally as well as a measure of executive functioning. CLINICAL IMPLICATIONS This tool serves a need in many professional settings (e.g., doctor's offices and Adult Protective Services) for a brief, standardized assessment measure of financial exploitation risk. This measure also provides actionable information for professionals to follow up with the standard of care for their clients.
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Affiliation(s)
- Rebecca J Campbell
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, Michigan, USA
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10
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Nguyen AL, Mosqueda L, Windisch N, Weissberger G, Axelrod J, Han SD. Perceived Types, Causes, and Consequences of Financial Exploitation: Narratives From Older Adults. J Gerontol B Psychol Sci Soc Sci 2021; 76:996-1004. [PMID: 33423064 DOI: 10.1093/geronb/gbab010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The goal of this study was to investigate the perception of financial exploitation and its causes and consequences by older adults who have firsthand experience of being exploited. METHOD Thirty-one cognitively healthy older adult participants aged 50 or older were drawn from the Finance, Cognition, and Health in Elders Study. In-depth, one-on-one interviews were conducted. Interview transcripts were analyzed using an iterative, data-driven, thematic coding scheme and emergent themes were summarized. RESULTS Categories of financial exploitation included (a) investment fraud, (b) wage theft/money owed, (c) consumer fraud, (d) imposter schemes, and (e) manipulation by a trusted person. Themes emerged around perceived causes: (a) element of trust, (b) promise of financial security, (c) lack of experience or awareness, (d) decision-making, and (e) interpersonal dynamics. Perceived consequences included negative and positive impacts around (a) finances, (b) financial/consumer behaviors (c) relationships and trust, (d) emotional impact, and (e) future outlook. DISCUSSION These narratives provide important insights into perceived financial exploitation experiences.
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Affiliation(s)
- Annie L Nguyen
- Department of Family Medicine, University of Southern California, Keck School of Medicine, Alhambra, USA
| | - Laura Mosqueda
- Department of Family Medicine, University of Southern California, Keck School of Medicine, Alhambra, USA
| | - Nikki Windisch
- Department of Family Medicine, University of Southern California, Keck School of Medicine, Alhambra, USA
| | - Gali Weissberger
- The Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Jenna Axelrod
- Department of Family Medicine, University of Southern California, Keck School of Medicine, Alhambra, USA
| | - S Duke Han
- Department of Family Medicine, University of Southern California, Keck School of Medicine, Alhambra, USA
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11
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Lichtenberg PA, Campbell R, Hall L, Gross EZ. Context Matters: Financial, Psychological, and Relationship Insecurity Around Personal Finance Is Associated With Financial Exploitation. THE GERONTOLOGIST 2021; 60:1040-1049. [PMID: 32211847 DOI: 10.1093/geront/gnaa020] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Context can influence or overwhelm the intellectual and cognitive aspects of financial decision making but has only recently received increased attention. The construct validity of conceptual subscales from a financial decision-making scale was examined in the context of their relationship to financial exploitation. RESEARCH DESIGN AND METHODS Two hundred forty-two community-based participants were recruited into the study. The final sample contained 242 participants. Measures included demographic variables, conceptually derived contextual items, and neurocognitive measures. Seventeen of the 34 contextual items investigated differentiated financially exploited and nonexploited older adults. Combining these 17 contextual items led to the creation of a new scale: the Financial Exploitation Vulnerability Scale (FEVS). Correlational analyses and area under the curve analyses were used to examine the relationship between this new scale of contextual items and other measures and to determine how clinically meaningful the scale was in the current sample. RESULTS Contextual items were powerful discriminators between those who were exploited and those who were not. The new scale of contextual items (the FEVS) demonstrated good internal consistency (Cronbach's alpha = 0.82) and a strong area under the curve (receiver operating characteristic = 0.80), thereby indicating good clinical significance and evidence for construct validity. DISCUSSION AND IMPLICATIONS We examined the conceptually derived subscales of financial awareness, psychological vulnerability, and relationship strain and how these relate to financial exploitation. Our major finding is that contextual items differentiated between exploited and nonexploited adults, which demonstrate the importance of measuring context in financial decision making and exploitation. A new scale for measuring contextual items was introduced.
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Affiliation(s)
- Peter A Lichtenberg
- Department of Psychology, Institute of Gerontology, Wayne State University, Detroit, Michigan
| | - Rebecca Campbell
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, Michigan
| | - LaToya Hall
- Department of Psychology, Institute of Gerontology, Wayne State University, Detroit, Michigan
| | - Evan Z Gross
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, Michigan
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12
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Lee K, Tang W, Jones S, Xu L, Cong Z. The Money Smart for Older Adults Program: A Qualitative Study of the Participants' Financial Well-Being. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2021; 64:120-134. [PMID: 32942947 DOI: 10.1080/01634372.2020.1814477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
The Money Smart for Older Adults is a program that is tailored to older adults to raise awareness for the risk of financial exploitation and teach them how to plan and make informed financial decisions. The purpose of this study was to examine financial circumstances of older adults in the program and to explore how the program could better support their financial well-being. Individual, in-depth interviews were conducted with 29 older adults who attended the program provided by a local agency in northern Texas. Three themes emerged when exploring financial circumstances of the participants: (1) victims of financial fraud scams, (2) struggles with money management, and (3) inability to make ends meet. The program has been serving older adults, particularly ethnically diverse older adults and low-income older adults who may not have access to financial education workshops or seminars provided by private financial institutions. The Money Smart for Older Adults Program was perceived as helpful among the participants because it raised awareness of the importance of their financial well-being and it also supported their financial decision making.
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Affiliation(s)
- Kathy Lee
- School of Social Work, University of Texas , Arlington, TX, USA
| | - Weizhou Tang
- Leonard Davis School of Gerontology, University of Southern California , Los Angeles, CA, USA
| | - Sarah Jones
- School of Social Work, University of Texas , Arlington, TX, USA
| | - Ling Xu
- School of Social Work, University of Texas , Arlington, TX, USA
| | - Zhen Cong
- School of Social Work, University of Texas , Arlington, TX, USA
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13
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Weissberger GH, Mosqueda L, Nguyen AL, Axelrod J, Nguyen CP, Boyle PA, Spreng N, Han SD. Functional Connectivity Correlates of Perceived Financial Exploitation in Older Adults. Front Aging Neurosci 2020; 12:583433. [PMID: 33304266 PMCID: PMC7693621 DOI: 10.3389/fnagi.2020.583433] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/14/2020] [Indexed: 12/28/2022] Open
Abstract
Financial exploitation (FE) in old age is devastating and common; however, the neural correlates of FE are poorly understood. Previous studies of FE in older adults have implicated declines in decision making and social cognition as two risk factors for FE in later life. Here we examined whether functional connectivity among brain regions implicated in decision making and social cognition differed for those with an experience of FE vs. those without. Participants included 16 older adults without cognitive impairment who reported FE (Mean age = 70.5, 62.5% female, Mean education = 16.0 years) and 16 demographically and cognitively matched adults who denied a history of FE (Mean age = 65.1, 37.5% female, Mean education = 15.1 years). Measures of whole-brain resting-state functional connectivity in the hippocampus, insula, and medial frontal cortex were derived for each group. Compared to the non-FE group, FE was associated with greater functional connectivity between the right hippocampus and bilateral temporal regions, and less functional connectivity between the right hippocampus and the right cerebellum and bilateral lingual gyri. The FE group showed less connectivity between the right and left insula and cingulate cortex, and between the right insula and regions of the left lateral temporal gyrus and dorsolateral prefrontal cortex. Finally, the FE group showed greater functional connectivity between the medial frontal cortex and the right lateral temporal gyrus and orbitofrontal cortex, and less functional connectivity with the right pre- and postcentral gyri. Results suggest that perceived FE in old age is associated with whole-brain functional connectivity differences involving the hippocampus, insula, and medial frontal cortex, consistent with models implicating age-associated changes in decision making and social cognition in FE.
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Affiliation(s)
- Gali H Weissberger
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, United States.,Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Laura Mosqueda
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, United States.,USC School of Gerontology, Los Angeles, CA, United States
| | - Annie L Nguyen
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, United States
| | - Jenna Axelrod
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, United States
| | - Caroline P Nguyen
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, United States
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.,Department of Behavioral Sciences and Psychiatry, Rush University Medical Center, Chicago, IL, United States
| | - Nathan Spreng
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.,Departments of Psychiatry and Psychology, McGill University, Montreal, QC, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - S Duke Han
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, United States.,USC School of Gerontology, Los Angeles, CA, United States.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.,Department of Behavioral Sciences and Psychiatry, Rush University Medical Center, Chicago, IL, United States.,Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, United States.,Department of Neurology, USC Keck School of Medicine, Los Angeles, CA, United States
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14
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Sunderaraman P, Chapman S, Barker MS, Cosentino S. Self-awareness for financial decision-making abilities in healthy adults. PLoS One 2020; 15:e0235558. [PMID: 32614887 PMCID: PMC7332073 DOI: 10.1371/journal.pone.0235558] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 06/17/2020] [Indexed: 11/19/2022] Open
Abstract
Objective Decades of research have established how to measure metacognition (i.e., awareness of one’s cognitive abilities), whereas relatively little is known about how to assess the integrity of financial awareness (FA; awareness of one’s financial abilities), a related construct with practical implications for vulnerable older adults. The current study’s goal was to apply established metacognitive frameworks to identify an objective measure of FA. Methods Metacognitive ratings were integrated into two financial decision making (FDM) assessments in order to derive two types of FA metrics: absolute accuracy (calibration) and relative accuracy (resolution) in each FDM task. Associations between each FA metric, demographic variables, FDM performances, and metamemory were examined. Design & setting Cross-sectional, community-based, prospective study. Participants 93 individuals with mean age = 59 years (SD = 15.12); mean education = 15.70 (SD = 2.39); 60% females. Measures FA was calculated using the Financial Competency Assessment Inventory (FCAI) and Decision Making Competence Assessment Tool, Finance Module (DMC-F), and memory awareness was calculated using an objective metamemory test. Results None of the FA metrics was associated with age, education or gender. FCAI calibration was inversely associated with FDM, and positively correlated with DMC-F calibration and metamemory calibration. None of the FA metrics for DMC-F was associated with metamemory. Conclusions Mirroring findings from metamemory studies, overconfidence in FDM was associated with lower FDM accuracy in healthy adults. Moreover, calibration scores on the FCAI and metamemory were related, suggesting that FA taps into metacognitive abilities. Our findings provide preliminary evidence for how to measure FA in both clinical and research contexts.
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Affiliation(s)
- Preeti Sunderaraman
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, NY, United States of America
- Gertrude. H. Sergievsky Center, Columbia University Medical Center, New York, NY, United States of America
- Department of Neurology, Columbia University Medical Center, New York, NY, United States of America
- * E-mail:
| | - Silvia Chapman
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, NY, United States of America
- Gertrude. H. Sergievsky Center, Columbia University Medical Center, New York, NY, United States of America
- Department of Neurology, Columbia University Medical Center, New York, NY, United States of America
| | - Megan S. Barker
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, NY, United States of America
- Gertrude. H. Sergievsky Center, Columbia University Medical Center, New York, NY, United States of America
- Department of Neurology, Columbia University Medical Center, New York, NY, United States of America
| | - Stephanie Cosentino
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, NY, United States of America
- Gertrude. H. Sergievsky Center, Columbia University Medical Center, New York, NY, United States of America
- Department of Neurology, Columbia University Medical Center, New York, NY, United States of America
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15
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Weissberger GH, Mosqueda L, Nguyen AL, Samek A, Boyle PA, Nguyen CP, Han SD. Physical and mental health correlates of perceived financial exploitation in older adults: Preliminary findings from the Finance, Cognition, and Health in Elders Study (FINCHES). Aging Ment Health 2020; 24:740-746. [PMID: 30739493 PMCID: PMC6933096 DOI: 10.1080/13607863.2019.1571020] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Financial exploitation (FE) in old age is poorly understood, particularly among those without significant cognitive impairment. The Finance, Cognition, and Health in Elders Study (FINCHES) aims to identify factors associated with FE among cognitively-healthy older adults. Preliminary findings regarding physical and mental health correlates in the pilot phase of FINCHES are reported.Method: Sixteen older adults who self-reported FE were demographically-matched on age, education, sex, and race/ethnicity to eighteen older adults who did not report past FE.Results: Those who believed they were exploited endorsed significantly greater symptoms of depression (p = 0.014) and marginally greater symptoms of anxiety (p = 0.062). Participants trended towards lower perceived successful aging (p = 0.094). Perceived FE participants also endorsed greater medical conditions (p = 0.047), but follow-up individual item analyses suggest that this was driven by problems with sleep (p = 0.030).Conclusions: These preliminary findings from the pilot phase of FINCHES highlight negative mental health factors associated with perceived FE among cognitively-intact older adults.
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Affiliation(s)
- Gali H. Weissberger
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, USA
| | - Laura Mosqueda
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, USA
| | - Annie L. Nguyen
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, USA
| | - Anya Samek
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Patricia A. Boyle
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;,Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Caroline P. Nguyen
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, USA
| | - S. Duke Han
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, USA;,Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;,Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA;,USC School of Gerontology, Los Angeles, CA, USA;,Department of Neurology, USC Keck School of Medicine, Los Angeles, CA, USA
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16
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Lichtenberg PA, Gross E, Ficker LJ. Quantifying Risk of Financial Incapacity and Financial Exploitation in Community-dwelling Older Adults: Utility of a Scoring System for the Lichtenberg Financial Decision-making Rating Scale. Clin Gerontol 2020; 43:266-280. [PMID: 29883276 PMCID: PMC6286690 DOI: 10.1080/07317115.2018.1485812] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Objectives: This work examines the clinical utility of the scoring system for the Lichtenberg Financial Decision-making Rating Scale (LFDRS) and its usefulness for decision making capacity and financial exploitation. Objective 1 was to examine the clinical utility of a person centered, empirically supported, financial decision making scale. Objective 2 was to determine whether the risk-scoring system created for this rating scale is sufficiently accurate for the use of cutoff scores in cases of decisional capacity and cases of suspected financial exploitation. Objective 3 was to examine whether cognitive decline and decisional impairment predicted suspected financial exploitation.Methods: Two hundred independently living, non-demented community-dwelling older adults comprised the sample. Participants completed the rating scale and other cognitive measures.Results: Receiver operating characteristic curves were in the good to excellent range for decisional capacity scoring, and in the fair to good range for financial exploitation.Conclusions: Analyses supported the conceptual link between decision making deficits and risk for exploitation, and supported the use of the risk-scoring system in a community-based population.Clinical Implications: This study adds to the empirical evidence supporting the use of the rating scale as a clinical tool assessing risk for financial decisional impairment and/or financial exploitation.
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Affiliation(s)
- Peter A Lichtenberg
- Institute of Gerontology & Merrill Palmer Skillman Institute, Professor of Psychology, Wayne State University, Detroit, MI, United States
| | - Evan Gross
- Institute of Gerontology & Department of Psychology, Institute of Gerontology, Detroit, MI, United States
| | - Lisa J Ficker
- Institute of Gerontology, Wayne State University, Detroit, MI, United States
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17
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Abstract
Objectives: This article examines the convergent validity and clinical utility of the 34-item short form of the Lichtenberg Financial Decision Rating Scale (LFDRS-SF). A briefer scale can lead to enhanced and efficient use of a person-centered approach to the assessment of financial decision-making.Methods: Using data on 200 community-dwelling older adults from Lichtenberg and colleagues (2017a), convergent validity was examined with cognitive and financial management measures using a correlational and regression approach. Receiver operating curve analyses for predicting decision-making ability classification and suspected financial exploitation classification were used to evaluate clinical utility.Results: The LFDRS-SF total risk score was significantly correlated with both cognitive and financial management measures, and the regression analysis predicted 9% of the LFDRS-SF measure. These results demonstrate not only convergent validity, but also the conceptual and empirical uniqueness of financial decision-making.Conclusions: The LFDRS-SF is a valid tool to assess real-world financial decision-making abilities.Clinical Implications: The LFDRS-SF offers an efficient way to assess financial decision-making. Training on the tool and automatic scoring and recommendations for next steps can be found at https://olderadultnestegg.com.
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Affiliation(s)
| | - Evan Gross
- Department of Psychology and Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Rebecca Campbell
- Department of Psychology and Institute of Gerontology, Wayne State University, Detroit, MI, USA
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18
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Rooks B, Anthony M, Chen Q, Lin Y, Baran T, Zhang Z, Lichtenberg PA, Lin F. A generic brain connectome map linked to different types of everyday decision-making in old age. Brain Struct Funct 2019; 225:1389-1400. [PMID: 31858236 DOI: 10.1007/s00429-019-02013-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 12/14/2019] [Indexed: 12/18/2022]
Abstract
Making reasonable decisions related to financial and health scenarios is a crucial capacity that can be difficult for older adults to maintain as they age, yet few studies examine neurocognitive factors that are generalizable to different types of everyday decision-making capacity. Here we propose an innovative approach, based on individual risk-taking preference, to identify neural profiles that may help predict older adults' everyday decision-making capacity. Using performance and cognitive arousal information from two gambling tasks, we identified three decision-making preference groups: ambiguity problem-solvers (A), risk-seekers (R), and a control group without strong risk-taking preferences (C). Comparisons of the number of connections within white matter tracts between A vs. C and R vs. C groups resulted in features consistent with the theory of dual neural functional systems involved in decision-making. Unique tracts from the A vs. C contrast were primarily centered in dorsal frontal regions/reflective system; unique tracts from the R vs. C contrast were centered in the ventral frontal regions/impulsive system; and shared tracts from both contrasts were centered in the basal ganglia, coordinating the switch between the two types of decision-making preference. Number of connections from the tracts differentiating A vs. C significantly predicted financial and health/safety decision-making capacity, and the association remained significant after controlling for multiple socioeconomic and cognitive factors. The connectome identified may provide insight into a generic white matter mechanism related to everyday decision-making capacity in older age.
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Affiliation(s)
- Brian Rooks
- Department of Biostatistics and Computational Biology, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, USA. .,Elaine C. Hubbard Center for Nursing Research On Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, USA.
| | - Mia Anthony
- Elaine C. Hubbard Center for Nursing Research On Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, USA.,Department of Brain and Cognitive Sciences, University of Rochester, Rochester, USA
| | - Quanjing Chen
- Elaine C. Hubbard Center for Nursing Research On Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, USA.,Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, USA
| | - Ying Lin
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, USA
| | - Timothy Baran
- Department of Imaging Science, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, USA.,Department of Biomedical Engineering, University of Rochester, Rochester, USA
| | - Zhengwu Zhang
- Department of Biostatistics and Computational Biology, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, USA.,Department of Neuroscience, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, USA
| | | | - Feng Lin
- Elaine C. Hubbard Center for Nursing Research On Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, USA. .,Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, USA. .,Department of Brain and Cognitive Sciences, University of Rochester, Rochester, USA. .,Department of Neuroscience, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, USA. .,Department of Neurology, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, USA.
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19
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Ghesquiere AR, McAfee C, Burnett J. Measures of Financial Capacity: A Review. THE GERONTOLOGIST 2019; 59:e109-e129. [PMID: 28535272 DOI: 10.1093/geront/gnx045] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Indexed: 11/13/2022] Open
Abstract
PURPOSE OF THE STUDY Capacity to manage finances and make financial decisions can affect risk for financial exploitation and is often the basis for legal determinations of conservatorship/guardianship. Several structured assessments of financial capacity have been developed, but have not been compared regarding their focus, validity, or reliability. Therefore, we conducted a review of financial capacity measures to examine these factors. DESIGN AND METHODS We searched electronic databases, reference lists in identified articles, conference proceedings and other grey literature for measures of financial capacity. We then extracted data on the length and domains of each measure, the population for which they were intended, and their validity and reliability. RESULTS We identified 10 structured measures of financial capacity. Most measures could be completed in 25-30 min, and were designed to be administered to older adults with some level of cognitive impairment. Reliability and validity were high for most. IMPLICATIONS Measurement of financial capacity is complex and multidimensional. When selecting a measure of financial capacity, consideration should be made of the population of focus and the domains of capacity to be assessed. More work is needed on the cultural sensitivity of financial capacity measures, their acceptability, and their use in clinical work. Better understanding of when, and to whom, to administer different financial capacity measures could enhance the ability to accurately detect those suffering from impaired financial capacity, and prevent related negative outcomes like financial exploitation.
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Affiliation(s)
- Angela R Ghesquiere
- Brookdale Center for Healthy Aging, Hunter College of the City University of New York
| | - Caitlin McAfee
- Brookdale Center for Healthy Aging, Hunter College of the City University of New York
| | - Jason Burnett
- Texas Elder Abuse & Mistreatment Institute (TEAM) McGovern Medical School, Department of Internal Medicine, Division of Geriatric and Palliative Medicine, The University of Texas Health Science Center at Houston
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20
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Lichtenberg PA, Hall L, Gross E, Campbell R. Providing Assistance for Older Adult Financial Exploitation Victims: Implications for Clinical Gerontologists. Clin Gerontol 2019; 42:435-443. [PMID: 30693849 PMCID: PMC7123962 DOI: 10.1080/07317115.2019.1569190] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background and Objective: Despite the growth of financial exploitation research in the past decade, almost none has focused on older urban adults, and especially urban African Americans. The Success After Financial Exploitation (SAFE) program provides individual financial coaching to older urban adults. Methods: We use community education, delivered separately to older adults and to the professionals who serve them, to raise awareness about financial exploitation (FE) and to motivate referrals for financial coaching. This paper describes the program and methodology, and uses case examples and preliminary research to investigate the intersection of FE and physical and mental health functioning. Results: SAFE participants were able to repair their credit scores, reduce new financial burdens, and even recover monies they had lost due to FE. Case examples illustrate how financial scams and identity theft impacts urban older adults. Participants were assessed prior to the provision of services, and SAFE participants performed poorer on executive functioning tasks than participants in the control group. They also reported more physical health problems and anxiety and depressive symptoms. SAFE participants also had significantly higher risk scores on a financial decision-making scale. Conclusion: Study findings advance our understanding of the impacts of FE on cognitive functioning, mental health, and financial decision-making. Clinical Implications: Clinicians need to be more attuned to the financial health of their older clients, who, if they are struggling with financial exploitation, may also be suffering from problems with cognitive functioning and physical and mental health.
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Affiliation(s)
| | - Latoya Hall
- Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Evan Gross
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Rebecca Campbell
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, MI, USA
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21
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MacLeod S, Musich S, Hawkins K, Armstrong DG. The growing need for resources to help older adults manage their financial and healthcare choices. BMC Geriatr 2017; 17:84. [PMID: 28399818 PMCID: PMC5387227 DOI: 10.1186/s12877-017-0477-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 04/05/2017] [Indexed: 11/24/2022] Open
Abstract
Background Both financial literacy (managing personal finances) and health literacy (managing personal health) become increasingly important for older adults, potentially impacting their quality of life. Resources in these constructs of literacy tend to be distinct, although the skills and decision-making involved overlap as financial issues impact healthcare choices. Thus the primary purpose of this commentary is to propose a new area of research focus that defines the intersection of financial and health literacy (i.e., financial health literacy). Methods We conducted a limited literature review related to financial, health, and health insurance literacy to demonstrate gaps in the literature and support our position. Online search engines were utilized to identify research in our primary areas of interest. Results We define the intersection of financial and health literacy as an area of need labeled financial health literacy, with a focus on four domains. These include: 1) the ability to manage healthcare expenses; 2) pay medical bills; 3) determine health needs and understand treatment options; and 4) make sound healthcare decisions with financial resources available. Despite some overlap with health insurance literacy, financial health literacy would define an area of need encompassing health management choices and health plan selections integrated with other financial management issues including living arrangements, financial planning, and retirement planning. Conclusions Potential initiatives should be considered to help at-risk older adults find resources to improve their financial health literacy, which in turn will enhance their abilities to manage medical choices in the environment of an increasingly complex healthcare system.
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Affiliation(s)
- Stephanie MacLeod
- Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI, 48108, USA.
| | - Shirley Musich
- Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI, 48108, USA
| | - Kevin Hawkins
- Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI, 48108, USA
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22
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Lichtenberg PA. Financial exploitation, financial capacity, and Alzheimer's disease. ACTA ACUST UNITED AC 2017; 71:312-20. [PMID: 27159438 DOI: 10.1037/a0040192] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Research in the past decade has documented that financial exploitation of older adults has become a major problem, and psychology is only recently increasing its presence in efforts to reduce exploitation. During the same time period, psychology has been a leader in setting best practices for the assessment of diminished capacity in older adults culminating in the 2008 American Bar Association Commission on Law and Aging and American Psychological Association (ABA/APA) joint publication on a handbook for psychologists. Assessment of financial decision-making capacity is often the cornerstone assessment needed in cases of financial exploitation. This article will examine the intersection of financial exploitation and decision-making capacity and introduce a new conceptual model and new tools for both the investigation and prevention of financial exploitation. (PsycINFO Database Record
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23
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Wood S, Lichtenberg PA. Financial Capacity and Financial Exploitation of Older Adults: Research Findings, Policy Recommendations and Clinical Implications. Clin Gerontol 2017; 40:3-13. [PMID: 28452630 PMCID: PMC5463983 DOI: 10.1080/07317115.2016.1203382] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Financial exploitation (FE) of older adults is a social issue that is beginning to receive the attention that it deserves in the mediathanks to some high profile cases, but empirical research and clinical guidelines on the topic are just emerging. OBJECTIVE Our review seeks to synthesize the current research in the area and develop a concentpual model. METHOD In this review, we describes the significance of the problem, proposes a theoretical model for conceptualizing FE, and summarizes related areas of research that may be useful to consider in the understanding of FE. RESULTS We identify key structural issues that have limited interventions in the past and make specific public policy recommendations in lightof the largest intergenerational transfer of wealth in history. CONCLUSIONS FE is a significant social problem, in this article we discuss implications for clinical practice.
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Affiliation(s)
- Stacey Wood
- a Scripps College , Claremont , California , USA
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24
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Spreng RN, Karlawish J, Marson DC. Cognitive, social, and neural determinants of diminished decision-making and financial exploitation risk in aging and dementia: A review and new model. J Elder Abuse Negl 2016; 28:320-344. [PMID: 27644698 PMCID: PMC8154217 DOI: 10.1080/08946566.2016.1237918] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
In this article we will briefly review how changes in brain and in cognitive and social functioning, across the spectrum from normal to pathological aging, can lead to decision-making impairments that increase abuse risk in many life domains (e.g., health care, social engagement, financial management). The review will specifically focus on emerging research identifying neural, cognitive, and social markers of declining financial decision-making capacity in older adults. We will highlight how these findings are opening avenues for early detection and new interventions to reduce exploitation risk.
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Affiliation(s)
- R. Nathan Spreng
- Laboratory of Brain and Cognition, Human Neuroscience Institute, Department of Human Development, Cornell University, Ithaca, New York, USA
| | - Jason Karlawish
- Center for Neuroscience and Society, Alzheimer’s Disease Center, Center for Bioethics, Departments of Medicine and Medical Ethics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daniel C. Marson
- Department of Neurology and Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
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25
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Lichtenberg PA, Ficker L, Rahman-Filipiak A, Tatro R, Farrell C, Speir JJ, Mall SJ, Simasko P, Collens HH, Jackman JD. The Lichtenberg Financial Decision Screening Scale (LFDSS): A new tool for assessing financial decision making and preventing financial exploitation. J Elder Abuse Negl 2016; 28:134-51. [PMID: 27010780 DOI: 10.1080/08946566.2016.1168333] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
One of the challenges in preventing the financial exploitation of older adults is that neither criminal justice nor noncriminal justice professionals are equipped to detect capacity deficits. Because decision-making capacity is a cornerstone assessment in cases of financial exploitation, effective instruments for measuring this capacity are essential. We introduce a new screening scale for financial decision making that can be administered to older adults. To explore the scale's implementation and assess construct validity, we conducted a pilot study of 29 older adults seen by APS (Adult Protective Services) workers and 79 seen by other professionals. Case examples are included.
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Affiliation(s)
- Peter A Lichtenberg
- a Institute of Gerontology , Wayne State University , Detroit , Michigan , USA.,b Department of Psychology , Wayne State University , Detroit , Michigan , USA
| | - Lisa Ficker
- a Institute of Gerontology , Wayne State University , Detroit , Michigan , USA
| | - Analise Rahman-Filipiak
- a Institute of Gerontology , Wayne State University , Detroit , Michigan , USA.,b Department of Psychology , Wayne State University , Detroit , Michigan , USA
| | - Ron Tatro
- c Center for Elder Rights Advocacy , Elder Law of Michigan , Lansing , Michigan , USA
| | - Cynthia Farrell
- d Aging and Adult Services, Adult Protective Services , State of Michigan Department of Health and Human Services , Lansing , Michigan , USA
| | - James J Speir
- e Speir Financial Services , Southfield , Michigan , USA
| | - Sanford J Mall
- f Mall, Malisow and Cooney, PC , Farmington Hills , Michigan , USA
| | - Patrick Simasko
- g Simasko and Simasko Law Firm , Mount Clemens , Michigan , USA
| | - Howard H Collens
- h Galloway and Collens, PLLC , Huntington Woods , Michigan , USA
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26
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Lichtenberg PA. New Approaches to Preventing Financial Exploitation: A Focus on the Banks. ACTA ACUST UNITED AC 2016; 26:15-17. [PMID: 27076776 DOI: 10.1093/ppar/prv032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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