Alzheimer Disease: Adverse Financial Events Emerge Years Before Diagnosis

Individuals who develop Alzheimer disease and related dementias (ADRD) likely have adverse financial events that begin years before diagnosis, and become more frequent after diagnosis, according to new findings published in JAMA Internal Medicine.

“Families should be counseled about the potential need to help with financial management following ADRD diagnosis,” the authors of the study wrote.

They arrived at their conclusion after performing a retrospective secondary data analysis (N = 81,364) of consumer credit report outcomes from 1999 to 2018 that had been linked to Medicare claims data. The Medicare beneficiaries who lived in single-person households comprised the study population. The main outcomes of the study were defined as missed payments on credit accounts (late by 30 days or more) and suboptimal credit scores.

A total of 27,302 patients (mean age 79.4 years) had ADRD for at least 1 quarter of the observation period, whereas 54,062 patients (mean age 74 years) never received a diagnosis of ADRD during the sample period. The results of the study indicated that single Medicare beneficiaries with a diagnosis of ADRD had a higher likelihood of missing credit account payments as early as 6 years before receiving their diagnosis (7.7%), compared with demographically similar Medicare beneficiaries without ADRD (7.3%).

Beneficiaries with an ADRD diagnosis were also more likely to develop suboptimal credit scores 2.5 years before diagnosis (8.5%) compared with beneficiaries without ADRD (8.1%). Patients with ADRD were still more likely to miss credit payments by the quarter after diagnosis (7.9%) compared with beneficiaries without ADRD (6.9%), and also remained more likely to have suboptimal credit scores (8.2%) compared with beneficiaries without ADRD (7.5%).

The authors noted that patients with ADRD in in lower-education census tracts more frequently experienced adverse financial events, and that the patterns of adverse events that occurred among patients with ADRD were unique compared with other health conditions such as hip fracture and glaucoma.

“Even without effective medical treatments, earlier detection of cognitive impairment might help protect older adults and their families from adverse financial outcomes,” the authors concluded.

—Christina Vogt

Reference:
Hersch Nicholas L, Langa KM, Bynum JPW, Hsu JW. Financial presentation of Alzheimer disease and related dementias. JAMA Intern Med. Published online November 30, 2020. doi:10.1001/jamainternmed.2020.6432