Cross-Validation of the Financial Exploitation Vulnerability Scale.

OBJECTIVES: The present study is a cross-validation of the Financial Exploitation Vulnerability Scale (FEVS), a measure of contextual risk for financial exploitation. METHODS: The sample was drawn from both the community and the SAFE program, a service for older adults who have been financially scammed. FEVS was administered within a larger assessment battery. The total score ability to differentiate exploitation groups and its correlates were examined. ROC analysis and logistic regression evaluated the clinical utility of the FEVS to detect exploitation. Results were compared to the initial validation study. RESULTS: FEVS score was significantly higher for those who were exploited and correlated with age. ROC analysis revealed adequate detection of financial exploitation. FEVS total score remained a strong predictor of exploitation when compared to demographic factors and several measures of cognitive functioning. CONCLUSIONS: Cross-validation demonstrates strong evidence that the FEVS detects financial exploitation in older adults, beyond the ability of many known risk factors. CLINICAL IMPLICATIONS: FEVS is an evidence-based tool for identifying exploitation and is accessible to many professionals working with older adults. Items query contextual factors that allow professionals to support clients with the appropriate standard of care.

Age Modifies the Interactive Effect of Loneliness and Social Support on Financial Exploitation Vulnerability in Older Adults.

Social support and loneliness have been identified as important correlates of financial exploitation vulnerability (FEV) in older adults. However, the potential combined effect of these social factors on FEV remains unclear. Moreover, given that social support and loneliness may become more important as age increases, age may have a moderating effect on the loneliness-social support interaction. Participants were 342 community-living Israeli older adults aged 60 or over (M age = 73.37, SD = 7.82, 69.1% female) who responded to questionnaires assessing FEV (Financial Exploitation Vulnerability Scale), perceived social support (The Multidimensional Scale of Perceived Social Support), loneliness (UCLA Three-item Loneliness Scale), and sociodemographic characteristics. Two hierarchical linear regression models covarying for demographic variables examined study hypotheses. In a first model, a significant interaction between social support and loneliness was discovered such that high levels of perceived social support attenuated the positive loneliness-FEV association. In a second model, a significant three-way interaction between social support, loneliness, and age was discovered. Probing the interaction revealed that the attenuating effect of social support on the loneliness-FEV link increased with increasing age. Findings suggest that effects of social factors on FEV may interact with each other and with age to predict FEV, and provide insights into when social support may be most relevant in mitigating FEV.

Lower entorhinal cortex thickness is associated with greater financial exploitation vulnerability in cognitively unimpaired older adults.

Research suggests that increased financial exploitation vulnerability due to declining decision making may be an early behavioral manifestation of brain changes occurring in preclinical Alzheimer's disease. One of the earliest documented brain changes during the preclinical phase is neurodegeneration in the entorhinal cortex. The objective of the current study was to examine the association between a measure of financial exploitation vulnerability and thickness in the entorhinal cortex in 97 cognitively unimpaired older adults. We also investigated financial exploitation vulnerability associations with frontal regions typically associated with decision making (e.g. dorsolateral and ventromedial prefrontal cortices), and additionally examined the interactive effect of age and cortical thickness on financial exploitation vulnerability. Results showed that greater financial exploitation vulnerability was associated with significantly lower entorhinal cortex thickness. There was a significant interaction between age and entorhinal cortex thickness on financial exploitation vulnerability, whereby lower entorhinal cortex thickness was associated with greater financial exploitation vulnerability in older participants. When the group was divided by age using a median split (70+ and <70 years old), lower entorhinal cortex thickness was associated with greater vulnerability only in the older group. Collectively, these findings suggest that financial exploitation vulnerability may serve as a behavioral manifestation of entorhinal cortex thinning, a phenomenon observed in suboptimal brain aging and preclinical Alzheimer's disease.

Perceived Financial Vulnerability, Wealth, and Wealth Change: The Health and Retirement Study.

OBJECTIVES: The 6-item Perceived Financial Vulnerability (PFV) scale assesses awareness and psychological vulnerability regarding finances. Prior findings using the Health and Retirement Study (HRS) identified significant associations of PFV with wealth, demographics, and health status. This study examines the relationship between wealth, changes in wealth, and PFV. METHODS: Data from HRS respondents were analyzed (N = 1,056). Total assets at baseline (2016) and changes in total assets over two waves (2016 to 2018) were stratified into deciles and used as primary predictors of PFV in 2018. Multiple linear regression models examined the influence of demographics, wealth change (linearly and curvilinearly), and baseline wealth on PFV. RESULTS: Wealth change and baseline wealth were associated with PFV. When controlled for baseline wealth, wealth loss linearly predicted increased PFV. CONCLUSIONS: These findings support the utility of the PFV. Findings underscore the importance of integrating multifaceted financial and demographic information when conceptualizing subjective financial welfare. CLINICAL IMPLICATIONS: Financial wellbeing is crucial in older clients and should be assessed over time. The 6-item PFV effectively evaluates contextual aspects of financial decision-making across socioeconomic statuses, making it valuable for clinical assessments.

Successful Aging Through Financial Empowerment (SAFE): Financial Coaching with Older Adult Victims of Financial Exploitation.

Financial exploitation (FE) of older adults is a growing public health problem. Current estimates of financial exploitation show between 5% and 11% of older adults are victimized each year. This study examined an empowerment-centered financial coaching intervention. Program records and participant baseline and follow-up assessment data were used to detail program dynamics and investigate participant outcomes. Most SAFE participants were very satisfied or satisfied (91%) with the services they received. Participants also reported significantly less stress at the six-month follow-up. These findings demonstrate that empowerment-centered financial coaching interventions can successfully address FE in older adult populations.

Neuropsychological profile associated with financial exploitation vulnerability in older adults without dementia.

Objective: Reports of financial exploitation have steadily increased among older adults. Few studies have examined neuropsychological profiles for individuals vulnerable to financial exploitation, and existing studies have focused on susceptibility to scams, one specific type of financial exploitation. The current study therefore examines whether a general measure of financial exploitation vulnerability is associated with neuropsychological performance in a community sample. Methods: A sample (n = 116) of adults aged 50 or older without dementia completed a laboratory visit that measures physical and psychological functioning and a neuropsychological assessment, the Uniform Data Set-3 (UDS-3) and California Verbal Learning Test-II. Results: After covarying for demographics, current medical problems, financial literacy, and a global cognition screen, financial exploitation vulnerability was negatively associated with scores on the Multilingual Naming Test, Craft Story Recall and Delayed Recall, California Verbal Learning Test-II Delayed Recall and Recognition Discriminability, Phonemic Fluency, and Trails B. Financial exploitation vulnerability was not associated with performance on Digit Span, Semantic Fluency, Benson Complex Figure Recall, or Trails A. Conclusions: Among older adults without dementia, individuals at higher risk for financial exploitation demonstrated worse verbal memory, confrontation naming, phonemic fluency, and set-shifting. These tests are generally sensitive to Default Mode Network functioning and Alzheimer's Disease neuropathology. Longitudinal studies in more impaired samples are warranted to further corroborate and elucidate these relationships.

Reflective Functioning and Financial Exploitation Vulnerability in Older Adults: The Importance of Significant Others.

OBJECTIVES: Financial exploitation of older adults results in devastating economic, social, and psychological losses to older adults, their families, and society at large. This study examined the relationship between reflective functioning and financial exploitation vulnerability (FEV) and whether relationship status moderated the association. METHODS: A community-based sample of 156 Israeli older adults age 60 and over responded to demographic questions and questionnaires assessing reflective functioning and FEV. RESULTS: A hierarchical linear regression analysis covarying for age, sex, education, income, and sum of illnesses, revealed that higher reflective functioning was associated with lower FEV (p = .011). A main effect of relationship status was not found, but a significant interaction of reflective functioning × relationship status was discovered (p = .008), adding 4.2% to the total variance of the model. Probing the interaction revealed that the reflective functioning-FEV association was significant only for older adults not in a relationship. CONCLUSIONS: Findings suggest that low reflective functioning may be associated with increased risk of financial exploitation, specifically in certain populations of older adults. CLINICAL IMPLICATIONS: Care providers of older adults may consider assessing for, and identifying older adults with low reflective functioning, in order to prevent or intervene in the event of a potentially exploitative situation.

Financial decision-making deficits in scam cases: how frequent are they?

Due to the rise in scams perpetrated against older adults, Adult Protective Service workers are more frequently involved in investigating these matters. One significant aspect of scam involvement is the assessment of informed financial decision-making. This study examined 175 consecutive scam cases APS workers investigated using a 10-item financial-decision making tool. Two-thirds of the sample displayed deficits in decision-making. The decision-making tool was effective in differentiating those rated as having deficits from those without deficits. Analysis of each scored item found differences between groups on six of the seven items. A review of the item responses illustrates the types of deficits in understanding and appreciation of the scam and its impact on the older person and their family.

A collaboration between adult protective services and forensic accounting examiners to investigate complex financial exploitation: formative evaluation findings.

Financial exploitation (FE) is one of the most common reports to Adult Protective Services (APS) and the cases are often complex. Consequently, APS caseworkers report FE investigations to be among the most difficult while simultaneously reporting low confidence in productive outcomes for these investigations. This necessitates finding ways to support APS FE investigations. This paper describes the structure, process, and formative findings of a collaboration between forensic accounting examiners and APS workers to investigate complex cases of FE. Among the 77 FE cases completed, forensic examiners reviewed multiple years of financial records which included over 101,000 transactions, totaling over $213,000,000.00 in finances, and identified over $8,000,000 in questionable activity. Scores on the 8-item Client Satisfaction Questionnaire were high indicating high program satisfaction by APS workers, subject matter experts, and forensic examiners. These findings support the feasibility and acceptability of forensic accounting and APS collaborations to investigate complex cases of FE.

Exploring the complex cognitive, affective and behavioural processes of individuals with intellectual disabilities in financially abusive situations.

BACKGROUND: Understanding the cognitive processes of individuals with intellectual disabilities in financially abusive situations is critical to develop effective prevention strategies. AIMS: This study investigated how persons with intellectual disabilities define and analyse financially abusive situations, and how they would feel and act in situations that they consider abusive. MATERIALS AND METHODS: Twelve participants with intellectual disabilities participated in a semi-structured interview where they were asked to reflect on three vignettes illustrating financial abuse. We analysed the interviews using thematic analysis. FINDINGS: The findings revealed that individuals with intellectual disabilities considered the type of relationship between the victims and the perpetrators, the behavioural patterns of the perpetrators, and their own experiences when interpreting the situation. Furthermore, they discussed their emotional and behavioural reactions to the vignettes. CONCLUSION: This study has important implications in supporting the autonomy and decision-making rights of persons with intellectual disabilities regarding their finances and developing effective preventions against financial abuse among this population.

Fraud victimization across the lifespan: evidence on repeat victimization using perpetrator data.

Older adults are thought to be more susceptible to scams, yet understanding the relationship between chronological age and victimization is limited by underreporting. This study avoids underreporting bias by merging four longitudinal databases of Americans (N = 1.33 million) who paid money in response to mail scams over 20 years. We investigate the risk of repeat victimization and victimization by multiple scam types over the life course. Victims in their 70s and 80s are 9% more likely to experience another victimization incident than those in their 50s. Those age 18 to 29 are 24% less likely to experience another victimization incident. Relative to adults in their 50s, the odds of victimization by multiple scams are greater for those in their 60s and 70s, but lower for those 80 + . This study demonstrates the research potential in using scammers' data to understand patterns of victimization. Fraud prevention efforts should target older individuals who are at higher risk of repeat victimization and suffer greater losses as a result.

Subjective Age Moderates the Relationship Between Global Cognition and Susceptibility to Scams.

This study examined the interactive effect of subjective age on the relationship between global cognition and susceptibility to scams. Sixty-five participants underwent an assessment of global cognition (Mini Mental State Examination; MMSE), reported their perceived age (i.e., subjective age), and responded to a self-report questionnaire assessing scam susceptibility. A main effect of global cognition on scam susceptibility was found (p = .028); there was no main effect of subjective age (p = .819). An interaction between global cognition and subjective age was found (p = .016). Examination of conditional effects demonstrated that the relationship between cognition and scam susceptibility was not significant amongst those with subjective ages below one standard deviation of the mean, but was significant for those whose subjective ages fell around or above the mean. Findings suggest that individuals with older subjective ages may be particularly vulnerable to the negative effects of lower cognition on scam susceptibility.

Subjective Age and Financial Exploitation Vulnerability: The Mediating Role of Financial Self-Efficacy.

An older subjective age, or feeling older than one's chronological age, has been associated with increased financial exploitation vulnerability (FEV) among older adults. However, the mechanisms behind this relationship have not been examined. This study examined whether financial self-efficacy mediates the relationship between subjective age and FEV. Participants were 156 Israeli older adults (M age= 66.97, SD = 6.46) who responded to questionnaires of subjective age, FEV, and financial self-efficacy. Correlations indicated that an older subjective age was associated with reduced financial self-efficacy (r= -.36, p < .001) and increased FEV (r = .51, p < .001). Testing the mediation model revealed an indirect effect of subjective age on FEV via financial self-efficacy (b = 1.57; bootstrapped 95% Cis [.80, 2.39]). Findings suggest that an older subjective age may reduce financial self-efficacy, thereby increasing FEV. Findings are discussed with regard to Stereotype Embodiment Theory and clinical implications are suggested.

Novel methods for assessment of vulnerability to financial exploitation (FE).

Financial exploitation (FE) is a complex problem influenced by many factors. This article introduces two novel methods for assessment of FE vulnerability: (1) performance-based measures of financial skills using web-based simulations of common financial tasks; (2) scam vulnerability measures based on credibility ratings of common scam scenarios. Older adults who were male, younger, Hispanic, more educated, with higher incomes performed better on the simulated financial tasks. Better performance was also related to higher cognitive function and numeracy, and more experience with technology. On the scenario-based measures, older adults who were male, younger, African American, less educated, and lower income showed higher FE vulnerability. Higher scam vulnerability was also related to poorer performance on the simulated financial tasks, lower cognitive function, less experience with technology, more financial conflict/anxiety, more impulsivity, and more stranger-initiated FE. Findings indicate that these novel measures show promise as valid indicators of vulnerability to FE.

Financial Fraud and Deception in Aging.

Financial exploitation among older adults is a significant concern with often devastating consequences for individuals and society. Deception plays a critical role in financial exploitation, and detecting deception is challenging, especially for older adults. Susceptibility to deception in older adults is heightened by age-related changes in cognition, such as declines in processing speed and working memory, as well as socioemotional factors, including positive affect and social isolation. Additionally, neurobiological changes with age, such as reduced cortical volume and altered functional connectivity, are associated with declining deception detection and increased risk for financial exploitation among older adults. Furthermore, characteristics of deceptive messages, such as personal relevance and framing, as well as visual cues such as faces, can influence deception detection. Understanding the multifaceted factors that contribute to deception risk in aging is crucial for developing interventions and strategies to protect older adults from financial exploitation. Tailored approaches, including age-specific warnings and harmonizing artificial intelligence as well as human-centered approaches, can help mitigate the risks and protect older adults from fraud.

Financial exploitation and mental health among Holocaust survivors: the moderating role of posttraumatic symptoms.

OBJECTIVES: We examined whether anxiety and depressive symptoms associated with self-reported history of financial exploitation (FE) are more pronounced among Holocaust survivors (HS), especially those with high-level posttraumatic stress disorder (PTSD) symptoms. DESIGN: Self-report questionnaires completed online via Qualtrics. SETTING: An online-based survey conducted in Israel. PARTICIPANTS: A community-based cohort of 137 Israeli older adults born prior to 1945 were included in the study sample. HS (n = 61) were participants who reported living in a European country occupied or dominated by Nazi or pro-Nazi regimes between 1939 and 1945. Groups were further subdivided into survivors with low or high levels of PTSD symptoms (≥31 on the PTSD Checklist; PCL-5). MEASUREMENTS: Questionnaires assessed FE history, posttraumatic symptoms (PCL-5), depressive symptoms (PHQ-9), and anxiety (GAD-7). Age, education, self-rated health, and non-Holocaust lifetime adversity were also measured and included as covariates. RESULTS: Hierarchical linear regression models revealed that relationships between FE and depressive and anxiety symptoms were significant only among survivors (p = 0.005 and p = 0.008, respectively). The interaction between PTSD symptom level group and FE was also significant for both depressive (p = 0.007) and anxiety (p = 0.012) symptoms, such that survivors with PTSD who reported FE had significantly greater symptoms of depression and anxiety compared to all other groups. CONCLUSIONS: Findings suggest that the experience of FE may be particularly impactful among survivors who continue to struggle with posttraumatic symptoms related to the Holocaust. Future studies may consider examining whether findings are relevant to other groups with PTSD.

Trust and betrayal in older adult financial exploitation.

OBJECTIVES: Although the knowledge base regarding the financial exploitation of older adults is expanding, work to understand the subpopulations of older adult financial exploitation victims and their experiences is greatly needed. This study uses betrayal trauma theory (BTT) as the foundation for conceptualizing the harm that arises from elder family financial exploitation. METHODS: The study uses a cross-sectional design to investigate group differences among a total sample of 95 community-dwelling older adults, 32 of the participants (33.7%) were older adult victims of family financial exploitation and the remaining 63 (66.3%) were victims of financial exploitation perpetrated by strangers. RESULTS: The group of older adults who were victims of elder family financial exploitation had significantly lower functional ability scores, higher stress and financial exploitation vulnerability scores and lost more money on average than those victimized by strangers. CONCLUSION: The present study provides support that BTT provides a valuable framework for understanding why older adult family financial exploitation victims are more vulnerable than victims of exploitation committed by strangers. Attention to this subgroup of financially exploited older adults will provide improved understanding of the unique challenges these victims face and inform prevention and intervention services.

Why comply? Risk and efficacy perceptions drive compliance in mass marketing scams.

Using a mix-method design, we examined participants' willingness to respond to mass marketing scams (MMS). In Experiment 1, we examined the effect of age (young versus older) and letter style ("hot" versus "cold") on the intention to respond. The intention of responding was negatively associated with risk (p < .001) and having at least a high school education was positively associated with perception of benefits (b = .684, p < .001). In Experiment 2, we examined reward sensitivity on the intention to respond by manipulating reward amounts (low versus high) and the presence of an activation fee. The presence of an activation fee decreased intent to contact, but percentages remained high (25.75%). Analyses of qualitative data indicated that risk and benefit were both predicted by perceived self-efficacy. The results indicate that consumers' beliefs about their ability to control the outcomes of future interactions affected how they behaved when provided with MMS materials.

Cross-Validation of the Lichtenberg Financial Decision Rating Scale.

OBJECTIVES: The Lichtenberg Financial Decision Rating Scale (LFDRS) is a person-centered tool for analyzing the integrity of financial decision-making abilities. Initial studies supported its reliability and validity (Lichtenberg et al., 2020; Lichtenberg et al., 2017; Lichtenberg et al., 2015). This study examines the cross-validation of the LFDRS Scale to assess its concurrent validity with a measure of executive functioning and suspected financial exploitation (FE). METHODS: Ninety-five older adult community participants underwent an assessment session. The total LFDRS was significantly related to executive functioning. RESULTS: Trail Making Test Part B was the only significant predictor of the LFDRS total score in a regression equation. An independent sample t-test showed that victims of FE scored higher on the LFDRS than those who were not victims. CONCLUSIONS: These findings are consistent with the initial validation study of the LFDRS and the initial study on the intersection of decision-making and FE (Lichtenberg et al., 2017, 2020) and adds evidence supporting the LFDRS concurrent validity.

Clinical Implications:The LFDRS is a person-centered tool for assessing financial decision-making and can be used in clinical assessments of financial capacity.The LFDRS can be a useful tool for assessing decision-making capacity in those who have been FE.