The People's Perspective on Medicine

Falling for Scams Is a Sign of Cognitive Impairment

Older adults who show signs of falling for scams may be at risk for mental deterioration over the next several years.
Portrait of an old farmer isolated on black

If you are like most Americans, you’ve honed your ability to smell out a scam over the past few years. But not all older people have perfected these techniques. Falling for scams may be an early sign of cognitive impairment.

Older Adults Falling for Scams:

Con artists frequently prey on older people with dementia because they are easy marks. New research shows that inability to detect the signs of a scam can be an early sign of cognitive impairment (Annals of Internal Medicine, online April 15, 2019).

The researchers followed 935 older adults in and around Chicago for six years. The volunteers lived in their own homes and none had been diagnosed with dementia at the outset. At that time, they answered questions to reveal scam awareness. 

Every year thereafter, they took neuropsychological tests to reveal cognitive impairment. About 16 percent of the participants developed Alzheimer disease and 34 percent had mild cognitive impairment. Those who had shown they were susceptible to falling for scams were 56 percent more likely to be diagnosed with Alzheimer disease. In addition, people with low scam awareness were 47 percent more likely to develop mild cognitive impairment.

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Unfortunately, the measure of scam awareness the investigators used “is too weak for prediction at the individual level.” Consequently, this correlation isn’t perfect. A person who is fairly confused may still be suspicious of a scam. Sometimes an older person who appears to be doing well cognitively will become a victim. Overall, however, those who had trouble determining who is trustworthy were more likely to undergo mental deterioration.

Other Risk Factors for Cognitive Decline:

Over the years, scientists have uncovered a number of factors that could make people more vulnerable to cognitive impairment. Recently investigators reported a link between gum disease and the onset of dementia. In addition, Dr. Ruth Itzhaki of the University of Manchester has conducted decades of research on infection with herpes simplex 1 (cold sores).  This viral infection may contribute to the risk for Alzheimer disease. People who have a genetic susceptibility for this condition (APOe-E4) may be the only ones who need to worry about the link, however. 

Patients taking several anticholinergic drugs such as amitriptyline for depression or oxybutynin for overactive bladder are also at higher risk for dementia. Nonprescription diphenhydramine found in PM-type pain relievers has high anticholinergic activity. As a result, it too could contribute to cognitive difficulties. Older people who take benzodiazepines for insomnia or anxiety are also at risk. To learn more about medications that may harm memory, you might wish to read our Guide to Drugs and Older People.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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  • Boyle et al, "Scam awareness related to incident Alzheimer dementia and mild cognitive impairment: A prospective cohort study." Annals of Internal Medicine, April 16, 2019. DOI: 10.7326/M18-2711
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I do agree with all you are saying. It is quite unbelievable as to how ‘very low’ some people can drop to steal from seniors rather than find a way to bring help to them and get paid honestly for it.
There are so many scams ‘out there’ we can’t possibly do much other than be on guard. Didn’t Chicago just get scammed out of over $1,100,000? Not just dementia folks.

“May” … “may” … “may” … They don’t know with any reliable degree of certainty. Maybe their findings are right, but maybe there’s some ageism bias in here, too. People in my parents’ generation (and, indeed, my own) didn’t grow up needing to be aware of the daily threat of scams, and they’re having to learn to be suspicious of them and what to look for. And some scams are pretty insidious — even very intelligent people with completely healthy cognitive function can fall for them. Most of my parents’ generation aren’t very tech savvy, either — does that make them less cognitively healthy? No, it just means the world we live in now is very different from the world they grew up in and spent most of their active/working lives in and being older makes it a little harder to adapt. Honestly, I think I’d be more concerned about the people who are always suspicious of something — to me, that’s an indicator of an unhealthy mental outlook. Caution is always wise, but paranoia not so much. So just because Grandma or Grandpa doesn’t realize that email or that phone call is a scam doesn’t mean they’re heading down the road to dementia. Maybe they just haven’t learned the fine art of scam awareness yet.

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