Neuropathology characteristic of Alzheimer's disease (AD) begins to accumulate years to decades before cognitive changes are clinically detectable on standard neuropsychological tests. This presents a challenge for early intervention efforts and has spurred research on the identification of behavioral correlates of early neuropathological changes. Recent evidence suggests that financial exploitation vulnerability (FEV) due to impaired decision making may serve as an early behavioral manifestation of AD neuropathology, thereby indicating an increased likelihood for subsequent cognitive decline. An understanding of the underlying mechanisms of FEV is therefore warranted for the identification of individuals at risk for cognitive decline due to AD, and for empowering and protecting older adults vulnerable to financial exploitation. In the current review, we first highlight the devastating consequences of financial exploitation of older adults. We then summarize research on the cognitive, neuroimaging, and neuropathological correlates of FEV in older adults without dementia and propose a theoretical model in which early accumulation of AD pathology manifests as FEV. We conclude with clinical implications and directions for future research.
Bibliographical noteFunding Information:
This work was supported by grants from the National Institute on Aging , USA ( RF1AG068166 to SDH, K01AG064986 to ALN, T32AG000037 to ACL) and the Elder Justice Foundation , USA awarded to SDH. Figure created with BioRender.com. The authors have no conflicts of interest to disclose.
© 2022 Elsevier Ltd
- Alzheimer's disease
- Financial exploitation
- Older adults