By Alan Mozes HealthDay Reporter
MONDAY, Sept. 19, 2022 (HealthDay News) — As Americans age, millions end up suffering from dementia or some level of memory impairment and a diminished ability to think clearly and make decisions.
after a New study He says that despite these serious challenges, many older adults continue to manage their finances, often on their own, and despite acknowledging the difficulties in doing so.
“There has long been interest in the difficulty of making financial decisions faced by older adults with cognitive impairment,” noted study lead author Jing Li, associate professor of health economics at the University of Washington in Seattle. But her team was surprised by the high percentage – 75% or more – who seem to be managing their finances nonetheless.
“Many of them report having difficulty managing finances and living alone, yet owning a large amount of risky assets,” he told me.
To explore this issue, her group looked at data from a representative survey of adults in the United States conducted in 2018. They focused on nearly 8,800 men and women aged 65 or older whose cognitive health status (memory and thinking) could be determined. Statistically, that group represented nearly 51 million older Americans.
Just over half (55%) were women with an average age of 74.
Altogether, eight out of 10 individuals have not experienced any cognitive impairment so far.
But nearly 6% have mental illnessand about 14% experienced some level of reasoning ability – known asnondementia cognitive impairment(CIND). This group of one in five participants represents nearly 7.4 million Americans, and is likely to include relatively older people, black or Hispanic men and women, and less educated individuals, the team said.
However, most respondents said overall that they continued to manage their family’s finances. The study authors noted that of those who did so, nearly 57% of those with dementia and 15% of those with dementia described the process as difficult.
To complicate matters further: More than 40% of seniors who said they manage their finances also live alone.
The researchers said a lot is at stake.
Nearly a third of people with dementia or CIND said they had a large amount of “risk assets,” such as stocks and loans.
For example, the average value of portfolios was $215,000 among those with dementia, which means half were older, and about $125,000 among those with dementia, the study found.
This means, he told me, that proactive planning is a must.
“This includes both early screening for cognitive impairment and early financial planning — designating a financial representative or alternative decision maker — to prepare for the event when one loses cognitive ability,” she said.
Lee said the situation can be particularly difficult for those who are weak in thinking but have not yet developed dementia, because they may be unaware of the challenges they face in managing finances.
For those with dementia, Lee said more research is needed to find the best interventions to address money management. She said potential interventions might include engaging extended families, seeking financial advice and switching to simpler financial products.
“America needs to listen to this call for help,” said Karlawich, MD, professor of medicine at the University of Pennsylvania Health System’s Penn Memory Center, in Philadelphia. “The large proportions of people with cognitive impairment who manage their finances and report difficulty doing so is a frustrating, even frightening, finding.”
In his editorial, he said, it’s important for someone who works with seniors to ask them a simple question: “Do you have any difficulty managing your money?”
Often, he wrote, the question goes instead to someone else—such as a spouse or child—who is expected to report on the patient’s performance.
Karlawich noted that a person who has trouble managing their finances may need an assessment for mental impairment.
An editorial suggested that bankers and lenders should ask clients if they need help and should offer services to help them.
“America needs to create a reliable health care system, one that integrates monitoring and the preservation of health and wealth, and thus enhances the financial security and well-being of seniors,” Karlawich said.
The editorial noted that financial security is especially important for older Americans with cognitive impairment, as they may require years of costly long-term care and support.
SOURCES: Jing Li, Ph.D., MA, assistant professor, Health Economics, Comparative Health Outcomes, Institute for Politics and Economics, University of Washington, Seattle; Jason Karlawich, MD, professor of medicine, and co-director, Penn Center for Memory, University of Pennsylvania Health System, Philadelphia; JAMA Network is openSeptember 13, 2022, online
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