Vulnerability of Older Adults to Government Impersonation Scams.

Importance: Financial fraud and scams targeting older adults are on the rise and pose serious public health and economic threats. Research on the vulnerability of older adults to fraud and scams relies almost exclusively on self-reported data, which have several intrinsic limitations. Thus, how older adults truly respond to fraud attempts remains unclear. Objective: To explore the vulnerability of older adults to a US government impersonation scam. Design, Setting, and Participants: This cross-sectional study, conducted from October to December 2021 among communities in the greater Chicago metropolitan area, was framed as a fictitious government agency reaching out to older adults about a potential compromise of personal information relevant to their Social Security and Medicare benefits. Participants were older adults participating in the Rush Memory and Aging Project, an ongoing cohort study of chronic conditions of aging. Data analysis was performed from February to August 2023. Exposures: Participants were exposed to deceptive materials through mailers, emails, and phone calls by a live agent. Main Outcomes and Measures: Based on the phone call data, participants were classified into 3 groups: no engagement (participants who did not answer the phone or call in), engagement (those who answered or called in but were skeptical about the legitimacy of the outreach and did not give away personal information), and conversion (participants who answered or called in without skepticism, or confirmed that they did not change their personal information, or provided the last 4 digits of their Social Security number). Results: A total of 644 older adults (501 [77.8%] female, 143 [22.2%] male), with a mean (SD) age of 85.6 (7.5) years, were included. A total of 441 (68.5%) participants did not engage, 97 (15.1%) engaged but raised skepticism, and 106 (16.4%) converted. Older adults who engaged but with skepticism had the highest cognition and financial literacy, while those in the conversion group had the lowest scam awareness. No differences were observed in psychological and other behavioral measures by the levels of engagement. Conclusions and Relevance: In this cross-sectional study using a behavioral experiment that mimicked a real-world imposter scam, a sizable number of older adults engaged without skepticism. Results suggest that many older adults, including those without cognitive impairment, are vulnerable to fraud and scams.

Well-Being and Aging-Related Decline in Financial and Health Literacy in Advanced Age.

OBJECTIVES: Emerging evidence suggests that financial and health literacy deteriorates in advanced age. By contrast, well-being promotes health in aging. This study tested the hypothesis that well-being is associated with slower aging-related literacy decline. METHODS: Participants were 1,099 community-based older adults without dementia at baseline. Financial and health literacy was assessed at baseline and annually thereafter via a 32-item measure. Well-being was assessed at baseline via the 18-item version of Ryff's Scales of Psychological Well-Being. RESULTS: During up to 12 years of annual follow-up, literacy declined about 1 percentage point per year on average (ß = -0.91, standard error [SE] = 0.08, p < .001); however, there was considerable variation in change in literacy between participants (random slopes variance = 1.24, SE = 0.15, p < .001). In a linear mixed-effects model adjusted for age, sex, and education, higher well-being was associated with higher starting level of literacy (ß = 2.31, SE = 0.67, p = .001) and, critically, slower literacy decline (ß = 0.29, SE = 0.11, p = .01). The association of higher well-being with slower literacy decline persisted in models that additionally adjusted for income, medical conditions, depressive symptoms, and a robust measure of global cognition. DISCUSSION: This study suggests that well-being helps stave off aging-related literacy decline.

Financial fragility and scam susceptibility in community dwelling older adults.

We tested the hypothesis that financial fragility is associated with higher scam susceptibility in older adults without dementia. Data came from nearly 900 community-dwelling participants from two ongoing cohort studies of aging. Financial fragility was determined by assessing an individual's ability to access $2,000 within a month for an unexpected expense. Scam susceptibility was assessed via a 5-item instrument that measures perceptions and behaviors that predispose older adults to financial fraud and scams. On average, participants were 82 years of age. Nearly 10% reported financial fragility. Financial fragility was higher in Blacks and among those with fewer years of education, lower income, lower global cognition, lower literacy, and poorer financial decision-making. Regression analysis revealed that financially fragile older adults were more susceptible to scams. These data suggest that targeted efforts to reduce financial fragility and improve literacy and cognitive health are needed to prevent elder exploitation among diverse populations.

Metamemory and financial decision making in older adults without dementia.

OBJECTIVE: Metamemory refers to self-awareness of one's memory function, and the extent to which metamemory deficit impacts financial decision making is unknown. This study tested the hypothesis that metamemory deficit is associated with poor financial decision making among older adults without dementia. METHOD: Data came from 502 community-dwelling older adults participating in the Rush Memory and Aging Project. Metamemory deficit was determined empirically by contrasting subjective memory ratings with performance on objective memory tests. Larger discrepancy of self-rated memory scores from performance-based testing scores indicates greater deficit. Financial decision making was assessed using a performance-based measure. Multivariable regression analyses examined the association of metamemory deficit with financial decision making. RESULTS: Participants had a mean age of 83 years and a mean education of 15 years. Approximately 75% were female. On average, participants answered two thirds of the financial decision making questions correctly. Female sex, older age, lower education, and lower financial literacy were correlated with poorer financial decision making. In an ordinal logistic regression model controlled for demographics and financial literacy, an 1SD increase in metamemory deficit reduced the odds of having better financial decision making by approximately 15%, OR: 0.844, 95% CI [0.719-0.991]. This association persisted after further controlling for family income, early life socioeconomic status, depressive symptoms and executive function. CONCLUSIONS: Metamemory deficit in older adults is a potential indicator of impaired financial decision making. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Correlates of Susceptibility to Scams in Community-Dwelling Older Black Adults.

INTRODUCTION: Evidence suggests that older Black adults are frequent victims of financial fraud and exploitation. This study aims to identify the factors associated with scam susceptibility in older Black adults. METHODS: Participants were 383 older Black adults living in the Chicago metropolitan area (mean age = 78 years and 82% female). A scam susceptibility measure assessed perceptions and behaviors that predispose older adults to fraud and scams. Categories of age-associated factors, including cognition, physical health, psychosocial factors, personality, and behavioral economics, were measured using uniform systematic assessments. For each category separately, measures associated with scam susceptibility were identified via stepwise variable selection. RESULTS: Older age was associated with greater scam susceptibility. Further, the analysis revealed a robust association of cognitive health with scam susceptibility, particularly the domains of semantic and working memory. Psychological well-being was associated with susceptibility, as was neuroticism. Behavioral economic measures including financial and health literacy and financial and health decision-making ability were also implicated. In a final model that included all the measures initially retained by variable selection, semantic memory, psychological well-being, and financial and health literacy were independently associated with scam susceptibility. Moreover, the association of age was attenuated and no longer significant after adjusting for these correlates. DISCUSSION: Age-associated vulnerabilities, rather than age itself, predispose older Black adults to financial fraud and scams. The correlates of scam susceptibility in community-living older Black adults primarily involve cognitive health, psychological, and behavioral economic factors.

Adverse Impacts of Declining Financial and Health Literacy in Old Age.

OBJECTIVES: Inadequate financial and health literacy presents a formidable public health and economic challenge in old age. This study investigated declining financial and health literacy in relation to decision making performance, scam susceptibility and psychological wellbeing. DESIGN: Longitudinal study. SETTING: A community-based cohort in Northeastern Illinois, USA. PARTICIPANTS: One thousand fourty-six older adults who were free of dementia at baseline and underwent annual clinical and literacy assessments. MEASUREMENTS: Financial and health literacy, decision making, scam susceptibility, and psychological wellbeing were assessed using validated instruments. Linear mixed effects models estimated person-specific rates of change in financial and health literacy, and multivariable regression analyses examined the associations of declining literacy with subsequent levels of decision making, scam susceptibility, and psychological wellbeing. RESULTS: The mean age was 81 years and 76% were female. Over up to 10 years of annual follow-ups, the average financial and health literacy score dropped 1 percentage point a year. Substantial variability in decline was observed between participants. Faster decline in financial and health literacy was associated with poorer decision making, higher scam susceptibility, and lower psychological wellbeing. Notably, these associations were above and beyond the baseline literacy level and persisted even after controlling for cognition. CONCLUSIONS: Most community-dwelling older adults experience decline in financial and health literacy over time, but decline is not inevitable. Declining literacy is related to poorer decision making, greater scam susceptibility and lower wellbeing. These findings suggest that efforts to mitigate declining financial and health literacy may promote independence and wellbeing in old age.

Loneliness Interacts With Cognition in Relation to Healthcare and Financial Decision Making Among Community-Dwelling Older Adults.

BACKGROUND AND OBJECTIVES: Cognition is a known determinant of healthcare and financial decision making in old age. Social vulnerabilities also might play a role in such decisions; however, the evidence for this is less clear. Here, we examined the association of loneliness with decision making and tested the hypothesis that loneliness is associated with decision making via its interaction with global cognition. RESEARCH DESIGN AND METHODS: Participants were 1,121 nondemented older adults from the Rush Memory and Aging Project. Healthcare and financial decision making was assessed via a performance-based measure; loneliness was assessed via the De Jong Gierveld Loneliness Scale; and cognition was assessed via a 19-test neuropsychological battery. RESULTS: In a regression model adjusted for age, sex, and education, global cognition was associated with decision making (B = 2.43, SE = 0.14, p < .001) but loneliness was not (B = -0.04, SE = 0.11, p = .72). However, in a model including the interaction of loneliness with global cognition, the interaction was significant (B = 0.44, SE = 0.20, p = .03), such that the detrimental effect of loneliness on decision making was stronger when cognition was low. In secondary analyses examining the interaction of loneliness with 5 specific cognitive domains, the interaction between loneliness and working memory with decision making was significant (B = 0.35, SE = 0.15, p = .02). DISCUSSION AND IMPLICATIONS: Our results suggest that loneliness compromises healthcare and financial decision making among older adults with lower global cognition and, more specifically, lower working memory.

Emotional arousal may increase susceptibility to fraud in older and younger adults.

Financial fraud is a societal problem for adults of all ages, but financial losses are especially damaging to older adults who typically live on fixed incomes and have less time to recoup losses. Persuasion tactics used by fraud perpetrators often elicit high levels of emotional arousal; thus, studying emotional arousal may help to identify the conditions under which individuals are particularly susceptible to fraud. We examined whether inducing high-arousal positive (HAP) and high-arousal negative (HAN) emotions increased susceptibility to fraud. Older (ages 65 to 85) and younger (ages 30 to 40) adults were randomly assigned to 1 of 3 emotional arousal conditions in a laboratory task: HAP, HAN, or low arousal (LA). Fraud susceptibility was assessed through participants' responses to misleading advertisements. Both HAP and HAN emotions were successfully induced in older and younger participants. For participants who exhibited the intended induced emotional arousal, both the HAP and HAN conditions, relative to the LA condition, significantly increased participants' reported intention to purchase falsely advertised items. These effects did not differ significantly between older and younger adults and were mitigated in participants who did not exhibit the intended emotional arousal. However, irrespective of the emotional arousal condition to which older adults were assigned (HAP, HAN, or LA), they reported greater purchase intention than did younger adults. These results inform the literature on fraud susceptibility and aging. Educating consumers to postpone financial decisions until they are in calm emotional states may protect against this common persuasion tactic. (PsycINFO Database Record

How Does Survey Context Impact Self-reported Fraud Victimization?

Purpose of the Study: This study examines the effect of survey context on self-reported rates of personal fraud victimization, and explores if the effect is influenced by age and gender. Design and Methods: Participants (3,000U.S. adults) were randomly assigned to 1 of the 3 versions of a fraud victimization questionnaire: questions about fraud were identical across conditions, however, the context varies. One questionnaire asked about crime, one about consumer buying experiences, and a third focused only on fraud. Results: Participants who were asked about fraud victimization in the context of crime reported significantly less victimization (p < .05) than those in the fraud-alone condition, yet the number of reports from those asked within the context of a consumer survey did not differ from the fraud-alone condition. The effect of the crime context interacted with age (p < .05), such that there was no effect of survey context for the middle age group (35-64), and a strong effect for younger (25-34) and older (65 plus) adults. The combined effect of being female and older was associated with the greatest effect of crime context on self-reported fraud victimization. Implications: These findings inform the production of new surveys and guide the development of effective social and health policies.