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Weissberger GH, Bergman YS. Reflective Functioning and Financial Exploitation Vulnerability in Older Adults: The Importance of Significant Others. Clin Gerontol 2024:1-10. [PMID: 38389427 DOI: 10.1080/07317115.2024.2320921] [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: 02/24/2024]
Abstract
OBJECTIVES Financial exploitation of older adults results in devastating economic, social, and psychological losses to older adults, their families, and society at large. This study examined the relationship between reflective functioning and financial exploitation vulnerability (FEV) and whether relationship status moderated the association. METHODS A community-based sample of 156 Israeli older adults age 60 and over responded to demographic questions and questionnaires assessing reflective functioning and FEV. RESULTS A hierarchical linear regression analysis covarying for age, sex, education, income, and sum of illnesses, revealed that higher reflective functioning was associated with lower FEV (p = .011). A main effect of relationship status was not found, but a significant interaction of reflective functioning × relationship status was discovered (p = .008), adding 4.2% to the total variance of the model. Probing the interaction revealed that the reflective functioning-FEV association was significant only for older adults not in a relationship. CONCLUSIONS Findings suggest that low reflective functioning may be associated with increased risk of financial exploitation, specifically in certain populations of older adults. CLINICAL IMPLICATIONS Care providers of older adults may consider assessing for, and identifying older adults with low reflective functioning, in order to prevent or intervene in the event of a potentially exploitative situation.
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Affiliation(s)
- Gali H Weissberger
- Department of Social and Health Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Yoav S Bergman
- Faculty of Social Work, Ashkelon Academic College, Ashkelon, Israel
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2
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Marzbani B, Ayubi E, Barati M, Sahrai P. The relationship between social support and dimensions of elder maltreatment: a systematic review and Meta-analysis. BMC Geriatr 2023; 23:869. [PMID: 38110874 PMCID: PMC10726566 DOI: 10.1186/s12877-023-04541-6] [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] [Received: 05/09/2023] [Accepted: 11/30/2023] [Indexed: 12/20/2023] Open
Abstract
INTRODUCTION AND AIMS Many studies have investigated the relationship between social support and the prevention of elder abuse; however, their results are somehow inconsistent in terms of the association. This systematic review and meta-analysis aimed to investigate the published studies on the relationship between social support and the prevention of elder maltreatment. MATERIALS AND METHODS An electronic search was conducted until January 2023, using such databases as PubMed, Scopus, and Web of Science. The present research included cross-sectional, longitudinal, and case-control studies. Study selection, data extraction, and risk of bias assessment were conducted by two researchers independently. The Newcastle-Ottawa checklist was utilized to evaluate the quality of studies. The random effects model was employed to perform a meta-analysis. RESULTS In total, 32 studies were included in this systematic review, out of which 26 articles were eligible for meta-analysis. The results showed that 68.75% of the studies were of high quality, and there is a significant relationship between social support and elder maltreatment. Accordingly, the lack of social support increased overall maltreatment (odds ratio: 1.24, 95% confidence interval: 1.16-1.33; I2 = 92.3%, p = 0.000)). Moreover, lack of social support had an increasing effect on the level of psychological abuse (1.55, 1.18-2.04; 88.7%, p = 0.000), physical abuse (1.31, 0.42-4.11; 76.3%, p = 0.005), and neglect (2.02, 0.86-4.72; 87.9%, p = 0.000), which shows heterogeneities among the results of the included studies. On the contrary, the lack of social support showed a decreasing effect on financial abuse (0.92, 0.70-1.21; 62.1%, p = 0.022). CONCLUSION This systematic review provides evidence that social support in the form of structural or functional support may plays an important role in improving the quality of life of the elderly.
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Affiliation(s)
- Behnaz Marzbani
- Department of Public Health, School of health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Erfan Ayubi
- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Department of Public Health, School of Health, Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, 6517838695, Iran.
| | - Parvaneh Sahrai
- Department of Public Health, School of health, Hamadan University of Medical Sciences, Hamadan, Iran
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3
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Sur A, DeLiema M, Vock DM, Boyle P, Yu L. A Microsimulation of Well-Being and Literacy Interventions to Reduce Scam Susceptibility in Older Adults. J Appl Gerontol 2023; 42:2360-2370. [PMID: 37704219 PMCID: PMC10843831 DOI: 10.1177/07334648231196850] [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: 09/15/2023] Open
Abstract
Poor financial and health literacy and poor psychological well-being are significant correlates of scam susceptibility in older adults; yet, no research has examined whether interventions that target these factors may effectively reduce susceptibility. Using longitudinal data from older adults in the Rush Memory and Aging Project (MAP) (N = 1,231), we used microsimulations to estimate the causal effect of hypothetical well-being and literacy interventions on scam susceptibility over six years. Microsimulations can simulate a randomized trial to estimate intervention effects using observational data. We simulated hypotheticalinterventions that improved well-being or literacy scores by either 10% or 30% from baseline, or to the maximum scores, for an older adult population and for income and education subgroups. Simulations suggest thathypotheticalinterventions that increase well-being or literacy cause statistically significant reductions in scam susceptibility of older adults over time, but improving well-being caused a greater-albeit not significantly different-reduction compared to improving literacy.
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Affiliation(s)
- Aparajita Sur
- Department of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - David M. Vock
- Department of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Patricia Boyle
- Rush Alzheimer’s Disease Center, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Lei Yu
- Rush Alzheimer’s Disease Center, Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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Lim AC, Mosqueda L, Nguyen AL, Mason TB, Weissberger GH, Fenton L, Lichtenberg P, Han SD. Interpersonal dysfunction predicts subsequent financial exploitation vulnerability in a sample of adults over 50: a prospective observational study. Aging Ment Health 2023; 27:983-991. [PMID: 35583043 PMCID: PMC9672139 DOI: 10.1080/13607863.2022.2076210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/28/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVES The goal of this study was to test whether interpersonal dysfunction, characterized by loneliness and/or dissatisfaction with relationships, is an imminent predictor of financial exploitation vulnerability (FEV) among adults age 50+ within a 6-month observation period. This study also tests whether FEV prospectively predicts interpersonal dysfunction. METHODS Twenty-six adults aged 50 or older completed a study involving baseline data collection and 13 follow-ups over 6 months. Linear mixed models were used for primary analyses. RESULTS After adjustment for demographic, psychological and cognitive covariates, there were between-person effects of FEV and interpersonal dysfunction across follow-ups, suggesting that those with generally higher interpersonal dysfunction compared to other participants also reported greater FEV (B(SE) = 1.09(.33), p = .003). There was a within-person effect (B(SE) = .08(.03), p = .007) of elevated interpersonal dysfunction predicting greater FEV two weeks later across all follow-ups. Within-person effect of FEV was not predictive of interpersonal dysfunction (B(SE) = .25(.15), p = .10). There was also a significant effect of age (B(SE) = -.06(.02), p = .007), such that older individuals had lower FEV throughout follow-ups. CONCLUSION Among adults age 50+, individuals with higher interpersonal dysfunction relative to others in the study reported greater FEV throughout the 6-month observation period. Increased loneliness and social dissatisfaction, relative to one's average level, predicts subsequent increases in FEV, and may be an imminent risk factor for exploitation.
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Affiliation(s)
- Aaron C Lim
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
| | - Laura Mosqueda
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
| | - Annie L Nguyen
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
| | - Tyler B Mason
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Gali H Weissberger
- The Interdisciplinary Department of Social Sciences, Bar-Ilan University, Raman Gat, Israel
| | - Laura Fenton
- Department of Psychology, USC Dornsife College of Letters, Los Angeles, CA, USA
| | | | - S Duke Han
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
- Department of Psychology, USC Dornsife College of Letters, Los Angeles, CA, USA
- USC Leonard Davis School of Gerontology, Los Angeles, CA, USA
- Department of Neurology, Keck School of Medicine of USC, Los Angeles, CA, USA
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5
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Lamar M, Yu L, Leurgans S, Aggarwal NT, Wilson RS, Han SD, Bennett DA, Boyle P. Self-reported fraud victimization and objectively measured blood pressure: Sex differences in post-fraud cardiovascular health. J Am Geriatr Soc 2022; 70:3185-3194. [PMID: 35920078 PMCID: PMC9669148 DOI: 10.1111/jgs.17951] [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] [Received: 01/07/2022] [Revised: 06/02/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Over 5 million older Americans are victims of financial exploitation, schemes, and/or scams per year. Such victimization is associated with increased hospitalizations, admittance to skilled nursing facilities, and lower 5-year all-cause mortality survival rates. Despite this, associations with medical comorbidities like elevated blood pressure (BP) have not been examined. METHODS We investigated the association of self-reported fraud victimization (presence/absence) with objectively measured BP metrics leveraging cross-sectional and longitudinal data from over 1200 non-demented adults (75% female; age ~81 years) from the Rush Memory and Aging Project. We first examined cross-sectional associations between baseline fraud victimization and BP, then used longitudinal data to test the hypothesis that fraud victimization is associated with increases in BP after incident fraud. During up to 11 years of annual observation, participants were queried for fraud victimization and underwent serial BP measurements to calculate per visit averages of systolic and diastolic BP, mean arterial pressure (MAP), and pulse pressure. RESULTS Cross-sectional analyses established that fraud victimization at baseline was associated with higher BP values. Next, using longitudinal changepoint analyses, we showed that fraud victimization was associated with elevations in BP among men but not women. Specifically, men who reported incident fraud exhibited increases in all BP metrics post-fraud. CONCLUSION Results suggest an important link between fraud victimization and BP, particularly among men. Older men showed significant elevations in BP after incident fraud that, compounded over time, may portend other adverse health outcomes.
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Affiliation(s)
- Melissa Lamar
- Rush Alzheimer’s Disease Center, 1750 W Harrison Street, Suite 1000, Chicago, IL, 60612, USA
- Department of Psychiatry and Behavioral Sciences, 1645 W Jackson Blvd, Suite 400, Chicago, IL, 60612, USA
| | - Lei Yu
- Rush Alzheimer’s Disease Center, 1750 W Harrison Street, Suite 1000, Chicago, IL, 60612, USA
- Department of Neurological Sciences, 1653 W Congress Parkway, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Sue Leurgans
- Rush Alzheimer’s Disease Center, 1750 W Harrison Street, Suite 1000, Chicago, IL, 60612, USA
- Department of Neurological Sciences, 1653 W Congress Parkway, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Neelum T. Aggarwal
- Rush Alzheimer’s Disease Center, 1750 W Harrison Street, Suite 1000, Chicago, IL, 60612, USA
- Department of Neurological Sciences, 1653 W Congress Parkway, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Robert S. Wilson
- Rush Alzheimer’s Disease Center, 1750 W Harrison Street, Suite 1000, Chicago, IL, 60612, USA
- Department of Psychiatry and Behavioral Sciences, 1645 W Jackson Blvd, Suite 400, Chicago, IL, 60612, USA
- Department of Neurological Sciences, 1653 W Congress Parkway, Rush University Medical Center, Chicago, IL, 60612, USA
| | - S. Duke Han
- Rush Alzheimer’s Disease Center, 1750 W Harrison Street, Suite 1000, Chicago, IL, 60612, USA
- Department of Psychiatry and Behavioral Sciences, 1645 W Jackson Blvd, Suite 400, Chicago, IL, 60612, USA
- Department of Neurological Sciences, 1653 W Congress Parkway, Rush University Medical Center, Chicago, IL, 60612, USA
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA 91803
- Department of Neurology, Keck School of Medicine of USC, Los Angeles, CA 90033
- Department of Psychology, USC, Los Angeles CA 90007
- School of Gerontology, USC, Los Angeles CA 90007
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, 1750 W Harrison Street, Suite 1000, Chicago, IL, 60612, USA
- Department of Neurological Sciences, 1653 W Congress Parkway, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Patricia Boyle
- Rush Alzheimer’s Disease Center, 1750 W Harrison Street, Suite 1000, Chicago, IL, 60612, USA
- Department of Psychiatry and Behavioral Sciences, 1645 W Jackson Blvd, Suite 400, Chicago, IL, 60612, USA
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Weissberger G, Bergman YS. The association between subjective age and financial exploitation vulnerability among older adults: The moderating role of social support. J Elder Abuse Negl 2022; 34:314-324. [PMID: 35920779 DOI: 10.1080/08946566.2022.2108181] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Financial exploitation of older adults bears detrimental physical and psychological consequences. However, risk factors of financial exploitation vulnerability (FEV) remain elusive. In line with a growing awareness of the importance of subjective perceptions of the aging process for older adults' functioning and well-being, this study examined the connection between subjective age (feeling younger/older than one's chronological age) and FEV, and the moderating effect of social support on this connection. Data were collected from a convenience sample of 137 Israeli older adults (age range 60-89, M = 69.90, SD = 6.85), who completed scales of FEV, subjective age, and social support, as well as relevant socio-demographic information. Older subjective age was associated with increased FEV when social support was low, but not when social support was high. Results are discussed in line with Socio-Emotional Selectivity Theory and provide initial information pertaining to the relevance of subjective age perceptions to FEV in older adults.
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Affiliation(s)
- Gali Weissberger
- Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Yoav S Bergman
- Faculty of Social Work, Ashkelon Academic College, Ashkelon, Israel
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7
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Stewart CC, Yu L, Glover CM, Bennett DA, Wilson RS, Boyle PA. Purpose in Life and Cognition Interact to Impact Healthcare and Financial Decision Making in Old Age. J Appl Gerontol 2022; 41:1887-1895. [PMID: 35543174 DOI: 10.1177/07334648221095514] [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: 11/17/2022] Open
Abstract
Objectives: Little is known about the contribution of positive psychological factors, such as purpose in life, to healthcare and financial decision making in aging. Here, we examined the relationship between purpose and decision making and tested the hypothesis that purpose benefits decision making, particularly when cognition is limited. Methods: Participants were 1081 community-based older adults without dementia. Healthcare and financial decision making was measured via a 12-item performance-based instrument. Purpose was measured via a 10-item scale. Results: In a linear regression model adjusted for age, sex, and education, higher global cognition was associated with better performance on the decision making measure, as expected. Purpose was not directly related to decision making. However, the interaction of purpose with cognition was significant, such that greater purpose was associated with better decision making among persons with lower cognition. Discussion: Purpose in life may promote better decision making among older adults with lower cognition.
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Affiliation(s)
- Christopher C Stewart
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Crystal M Glover
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
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8
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Koga C, Tsuji T, Hanazato M, Takasugi T, Kondo K. Types of Elder Abuse and Dementia Onset among Older Adults in Japan: A 6-year Longitudinal Study from the Japan Gerontological Evaluation Study. Arch Gerontol Geriatr 2022; 100:104656. [DOI: 10.1016/j.archger.2022.104656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/27/2022] [Accepted: 02/07/2022] [Indexed: 11/02/2022]
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9
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Financial Fraud against Older People in Hong Kong: Assessing and Predicting the Fear and Perceived Risk of Victimization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031233. [PMID: 35162252 PMCID: PMC8835379 DOI: 10.3390/ijerph19031233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 11/17/2022]
Abstract
While the majority of studies on the fear of crime focus on the impact of violent and property crimes at the population level, financial fraud against senior citizens is often under-investigated. This study uses data collected from 1061 older citizens in the community through a cross-sectional survey in Hong Kong to examine the levels of fear and perceived risk among Chinese senior citizens toward financial fraud and the factors behind them. Logistic regression analyses were conducted to assess the explanatory power of four theoretical perspectives (vulnerability, victimization, social integration, and satisfaction with police) on fear and perceived risk of fraud victimization. The results indicate significant predictive effects of victimization experience and satisfaction with police fairness and integrity on both the fear and the perceived risk of fraud among respondents. The findings not only confirm the differential impact of theoretical explanations on these constructs but can also contribute to crime prevention policy and practice in an aging society.
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10
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Financial abuse of older people by third parties in banking institutions: a qualitative exploration. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21001574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Financial abuse is a significant form of elder maltreatment and is frequently ranked in the top two most common forms of abuse perpetration. Despite this, it is under-identified, under-reported and under-prosecuted. Financial institutions, such as banks, are important environments for identifying and responding to the financial abuse of older people. Traditionally, banks have not always been part of inter-sectorial responses to financial abuse, yet are important stakeholders. The aim of this study is to explore perceptions and experiences of financial abuse in five national banks. Data were collected from 20 bank managers and five members of the National Safeguarding Committee in the Republic of Ireland. Using thematic analysis, four themes were identified: defining a vulnerable adult; cases of financial abuse of vulnerable adults; case responses to financial abuse of vulnerable adults; and contextual issues. The data demonstrate the multiplicity of manifestations and the complexity of case investigation and management. Findings point to the need to enhance banks’ responses, through additional education and training, and promote integrated inter-sectorial collaboration. In addition, a change in societal beliefs is needed regarding financial entitlement, responding to ageism, public awareness of the consequences of financial decisions and types of financial abuse, as well as ensuring such crimes are addressed within the legal system.
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11
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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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12
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Stewart CC, Yu L, Glover CM, Mottola G, Bennett DA, Wilson RS, Boyle PA. Loneliness Interacts With Cognition in Relation to Healthcare and Financial Decision Making Among Community-Dwelling Older Adults. THE GERONTOLOGIST 2021; 60:1476-1484. [PMID: 32574350 DOI: 10.1093/geront/gnaa078] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Cognition is a known determinant of healthcare and financial decision making in old age. Social vulnerabilities also might play a role in such decisions; however, the evidence for this is less clear. Here, we examined the association of loneliness with decision making and tested the hypothesis that loneliness is associated with decision making via its interaction with global cognition. RESEARCH DESIGN AND METHODS Participants were 1,121 nondemented older adults from the Rush Memory and Aging Project. Healthcare and financial decision making was assessed via a performance-based measure; loneliness was assessed via the De Jong Gierveld Loneliness Scale; and cognition was assessed via a 19-test neuropsychological battery. RESULTS In a regression model adjusted for age, sex, and education, global cognition was associated with decision making (B = 2.43, SE = 0.14, p < .001) but loneliness was not (B = -0.04, SE = 0.11, p = .72). However, in a model including the interaction of loneliness with global cognition, the interaction was significant (B = 0.44, SE = 0.20, p = .03), such that the detrimental effect of loneliness on decision making was stronger when cognition was low. In secondary analyses examining the interaction of loneliness with 5 specific cognitive domains, the interaction between loneliness and working memory with decision making was significant (B = 0.35, SE = 0.15, p = .02). DISCUSSION AND IMPLICATIONS Our results suggest that loneliness compromises healthcare and financial decision making among older adults with lower global cognition and, more specifically, lower working memory.
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Affiliation(s)
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Crystal M Glover
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Gary Mottola
- FINRA Investor Education Foundation, Washington, District of Columbia
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
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13
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Ries NM. Enduring Powers of Attorney and Financial Exploitation of Older People: A Conceptual Analysis and Strategies for Prevention. J Aging Soc Policy 2019; 34:357-374. [PMID: 31847789 DOI: 10.1080/08959420.2019.1704143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Enduring powers of attorney (POAs) are commonly used legal instruments that enable older people to plan for asset management in the event of future incapacity. The policy objective of POAs - empowering control over money and property - are frustrated when POAs are misused to financially exploit older people. This commentary integrates theory and evidence to propose a conceptual framework for POA-facilitated financial exploitation (POA-FE). Identified risk factors include inadequate knowledge about the POA role; family conflicts; attitudes of entitlement; and lack of planning and preparation for financial decision-making. POA-FE occurs on a continuum of behavior and strategies for preventing POA-FE are suggested using strengths-based approaches for older people and their attorneys.
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Affiliation(s)
- Nola M Ries
- Law Health Justice Research Centre, Faculty of Law, University of Technology Sydney, Sydney, Australia
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