Effects of Alzheimer s Disease in the Prediagnosis Period on Financial Outcomes
Abstract
Alzheimer s disease (AD) affects millions of people in the United States and tens of millions of people worldwide, exacting substantial human and monetary costs. An estimated 5.3 million people in the United States have AD. In the absence of a medical breakthrough to either prevent or slow the disease s progression, the number of persons aged 65 and older with AD is projected to nearly triple. The effect of AD on an individual s memory and judgment interfere with their ability to perform even the most basic functions of daily living and contribute to the devastating effect of the disease on those afflicted and their families. Diagnosis of AD currently occurs after the onset of symptoms severe enough to affect daily life. However, individuals afflicted with early-stage AD often experience rapid and significant declines in their ability to handle financial tasks. Some researchers have found that a reduced ability to handle decisions and tasks related to household finances is one of the first changes people with AD experience. Individuals in the early stages of AD -- so early that it cannot be diagnosed using available tools -- may make risky investments, have trouble managing day-to-day financial responsibilities such as paying bills on time, and be especially susceptible to financial exploitation such as charity or home repair scams and "predatory" lending (loans with very high interest rates and penalties for nonpayment). Before AD is diagnosed, these changes in a person s ability to manage household finances may not be fully appreciated or recognized by individuals and their families. Consequently, poor financial decisions and financial exploitation may come to light only after a significant or catastrophic financial event. Little is known about how much AD, before it is diagnosable, might cost families and what its implications are for quality of life. The goal of this research is to understand how AD -- during the particularly vulnerable time before the disease is diagnosable -- affects the financial well-being of the individuals and families of those it afflicts. Our research will examine how AD affects household savings, debt, and spending, such as on charitable contributions. It will also examine how AD affects the family s financial security in terms of ability to pay for food and pay the mortgage. Our research will use a large survey of adults over 50 called the Health and Retirement Study (HRS). The survey has been going on since 1992 and includes information on the same households over time. These data allow us to track households for up to two decades and explore how the onset of AD changes their savings, spending, debt, and other financial behavior. We will link the HRS survey data with Medicare data to construct a profile of information for individuals who have been diagnosed with AD and when the first diagnosis occurs. (Medicare is the public health insurance program that insures nearly every person in the United States aged 65 and over). The Medicare data track individuals healthcare use and includes information that physicians have recorded about the health conditions an individual has. With information on date of diagnosis, we can use the HRS to look backward over time at the vulnerable period prior to an individual s diagnosis with AD. The proposed project is important because there is virtually nothing known about how changes in financial decisions made by individuals with early-stage AD affect their families, including consequent effects on quality of life. This research will inform the design and development of interventions to protect vulnerable individuals and their families during the critical and vulnerable time period before diagnosis by a physician.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610746
Entities
People
- Carole Gresenz
Organizations
- RAND Corporation
- United States Army