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Seniors Who Fall Prey To Scam Artists Might Be More Vulnerable To Alzheimer's, Dementia

CHICAGO (CBS) -- New research suggests seniors who have a hard time hanging up on telemarketers also might be at risk for eventually developing Alzheimer's disease, or other forms of dementia.

Scientists at Rush University Medical Center found seniors who fall victim to con artists have a higher risk for Alzheimer's, dementia, or mild cognitive impairment.

Elder fraud is a huge problem, and Monday's study doesn't mean that people who fall prey to a con artist have some sort of dementia brewing.

But scientists know that long before the memory problems of Alzheimer's become obvious, people experience more subtle changes in their thinking and judgment. Neuropsychologist Patricia Boyle of Rush University's Alzheimer's disease center wondered if one of the warning signs might be the type of judgment missteps that can leave someone susceptible to scams.

"When a con artist approaches an older person, they're looking for a social vulnerability — someone who is open to having a conversation with a complete stranger," said Boyle. Then the older person must interpret that stranger's intentions and emotions, with little else to go on, in deciding whether to believe what they're peddling, she explained.

Within a large group of older people showing no signs of dementia, those with little to no awareness of possible telephone fraud proved to be at higher risk for mild cognitive decline and, in some cases, Alzheimer's disease compared with those with a greater consciousness of potential cons, according to the study, published Monday in the journal Annals of Internal Medicine.

Boyle turned to data from the Financial Industry Regulatory Authority, which operates a fraud "risk meter," to determine behaviors that could signal scam vulnerability — things such as answering the phone when you don't recognize the number, listening to telemarketers, finding it difficult to end unsolicited calls, being open to potentially risky investments and not realizing that seniors often face financial exploitation.

Boyle studied 935 seniors, mostly in their 70s and 80s, with no known brain problems who were enrolled in a long-running memory and aging project in Chicago. They took a scam awareness questionnaire and then took yearly brain tests for an average of six years.

During the study, 151 seniors were diagnosed with Alzheimer's and another 255 with mild cognitive impairment, sometimes a precursor for Alzheimer's. The participants who'd had what Boyle calls low scam awareness at the study's start were more likely to have developed each of those conditions than seniors who were more aware of scam vulnerability.

"Social cognition -- social judgment -- involves a diverse array of functions," Boyle said. This "complicated behavior involves and integrates multiple different abilities, including cognition, including emotion regulation, including making inferences and perceptions about others' behavior as well as of course regulating one's own impulses."

The ability to discern whether someone is trustworthy is one example of social cognition.

"Because it's a complex behavior, it likely involves distributed brain networks to support it," Boyle said.

A growing body of work shows that poor financial decision-making or deficiencies in complex daily living tasks -- aspects of social cognition -- may occur before the appearance of obvious cognitive symptoms such as memory loss, she said.

For a closer look, the 264 participants who died during the study underwent brain autopsies. Sure enough, the lower the scam awareness at the study's start, the more people had a buildup of sticky plaque in their brains that is a hallmark of Alzheimer's, Boyle reported.

Boyle said the research "adds to our understanding of elder fraud in general. This work would suggest that, in fact, many cognitively intact older people also may be at risk of financial and other forms of fraud and abuse and really sheds new light on the scope of this problem."

The study can't prove a link between low scam awareness and impending decline in thinking and memory, cautioned Dr. Jason Karlawish of the University of Pennsylvania in an accompanying editorial.

Karlawish described one of his own patients who confessed to a grandson, "I think I've been had" by a lottery scam that persuaded him to pay taxes up-front so he could receive his purported winnings. It was just too hard to hang up on the polite caller. Three years later, that patient shows no sign of cognitive impairment, said Karlawish, who said he's flummoxed by how the clever crooks managed to rob the man.

Still, the study results "should be a call to action to health care systems, the financial services industry and their regulators," Karlawish wrote, urging further research into what he called "notable findings."

The possible scam link isn't surprising, agreed Alzheimer's Association vice president Beth Kallmyer, who also said it needs more research. In fact, she said seniors may be reluctant to report fraud for fear family members might suspect they were sucked in because of health problems.

Dementia concerns or not, she advises seniors simply to not answer unsolicited calls or emails from people they don't recognize, making it harder for them to be targeted.

Previous research has suggested that seniors can begin to have trouble managing their finances even with aging's normal cognitive slowing.

And the rise in elder fraud has reached such a level that investment firms now are supposed to ask customers for the contact information of a "trusted person" they can alert if they suspect a case of financial exploitation. Just last week, federal agents broke up a Medicare scam that sold unneeded orthopedic braces to hundreds of thousands of seniors. And every tax season the government warns people not to fall for phone calls from IRS impostors — that agency won't call for payment.

"As older people start making mistakes in financial, health care and other types of complex decisions, we do need to raise awareness and start asking, 'Do they need some help?'" Boyle said. "It doesn't necessarily mean someone is going to go on to develop dementia. But we should become more aware."

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