92 year old Ali Haydar Cilasun (R) holds the hand of carer Guven Asmacik (L) in his room at an Aliacare home for the elderly in Berlin on October 8, 2013. The Aliacare home offers bilingual services for German and Turkish elderly people. AFP PHOTO / ODD ANDERSEN        (Photo credit should read ODD ANDERSEN/AFP/Getty Images)
What is dementia?
01:16 - Source: CNN
CNN  — 

Patterns of missing credit card and loan payments could be an early indicator of dementia years before diagnosis, a new study says.

The study, published Monday in the medical journal JAMA, looked at Medicare patients living alone across the United States and analyzed their credit data and payments over time.

Researchers found that patients with Alzheimer’s disease and related dementia were more likely to miss payments up to six years before getting diagnosed, the study said. And, those poor financial actions led them to subprime credit scores two and a half years before diagnosis, as opposed to the patients without dementia.

“I think we were a little surprised that it was so common that we could really see it in the data,” lead author Lauren Hersch Nicholas told CNN. “Doctors colloquially say that you should look for dementia in the checkbook, but I don’t think we had any sense of for how many years in advance these effects could be happening.”

Nicholas is an associate professor at Johns Hopkins University. Researchers from Johns Hopkins and the Federal Reserve Board of Governors led the study.

Alzheimer’s dementia affects about 5.8 million Americans who are 65 and older, according to the Alzheimer’s Association. The number of Americans with the disease is projected to hit 13.8 million by 2050, the non-profit said.

Researchers looked at consumer credit report data from more than 81,000 Medicare recipients for almost a 20-year period, from 1999 to 2018, according to the study.

The wide data pool revealed that the patients who ultimately were diagnosed with dementia had early signs of financial symptoms.

“It’s upsettingly common,” Nicholas said. “At the height of our results, we’re finding dementia is accounting for between 5% and 20% of the missed payments among those who eventually developed dementia. Lots of other factors also cause you to miss making payments, but I think dementia turns out being one of the most important ones as well in this age group.”

Nicholas said she got into this area of study after watching her grandmother battle dementia. When her mother discovered an IRS notice sent to Nicholas’ grandmother, she offered to take care of her finances, Nicholas said.

The hope that comes from this study is that patients or their loved ones start to realize something is wrong before it’s too late, Nicholas said. That could look like someone losing their house or giving away their retirement money to a scammer.

“That’s this really scary potential side effect of dementia we haven’t previously been able to quantify,” Nicholas said. “Coming at it from an economics perspective, I knew we had the data and methods that would allow us to test whether some of these anecdotes really present in larger data sets, too. The depressing news is that they do.”

Patients with a lower level of education who later developed dementia started missing payments up to seven years before their diagnosis, the study said. Higher educated patients didn’t start showing financial symptoms until two and a half years before.

While financial literacy is often tied to someone’s level of education, the reason for the less educated patients developing the disease earlier is unclear.

“In that case we don’t know if it’s because they’re not getting health care as quickly and so that’s why we have a longer period, or the symptoms just materialize earlier for them,” Nicholas said.

Some would argue that other illnesses or diseases could contribute to a person’s decline in financial decision-making, but the study found otherwise.

The study compared people’s comorbid conditions against whether they developed dementia.

“We actually see very distinct patterns with dementia suggesting it’s more likely the cognitive decline than the typical burden of greater illness that’s driving this,” Nicholas said.

Lis Nielsen, director of the Division of Behavioral and Social Research at the National Institute on Aging, independently reviewed the study. The study was funded primarily by the NIA.

Nielsen said it’s hard to tell why the lower education group showed financial symptoms earlier on.

“There is the potential that diagnosis of dementia comes later for some less advantaged groups because lack of ability to get access to good care,” Nielsen told CNN. “We know from some minority groups that diagnosis is often later in those groups compared to well-off, White, socioeconomically advantaged individuals.”

The idea of financial symptoms being an early indicator of dementia isn’t new, she added.

“Decision-making deficits like this are not necessarily a normal part of aging,” Nielsen said. “It’s been known for a long time that financial capacity, or difficulties with financial decision-making, are an early marker and predictive of later dementia diagnosis.”

This research could help people realize earlier on that they may be showing signs of dementia, she said.

“Having a way to detect this early could be very helpful for people even in the absence of a cure for dementia just so they can keep their financial house in order and maybe bring on some source of support or intervention earlier before they make catastrophic mistakes,” Nielsen said.