Profiles of Vulnerability to Financial Exploitation in the Degenerative Dementias

Objective: Financial decisions are necessary for independent living. There is evidence that dementia and cognitive impairment can impair the ability to pursue financial skills and lead to vulnerability to financial exploitation. Frontotemporal dementia (FTD) and to a lesser extent Alzheimer's disease (AD) promote susceptibility to deception. There is little evidence for other forms of degenerative dementia. To explore this topic, we developed a questionnaire that assesses financial behavior in four dementias: Alzheimer's disease (AD), behavioral variant Frontotemporal Dementia (bvFTD), semantic variant of Primary Progressive Aphasia (svPPA), and dementia with Lewy bodies (LBD). Design, Setting, Participants: Participants were 166 consecutive patients with dementia (78 AD, 34 bvFTD, 22 svPPA, 32 LBD) involved in a cross-sectional study exploring financial frailty. Measurements: An experimental questionnaire, the Financial Frailty Battery (FFB), was administered to caregivers who were asked to report any behavioral changes after the onset of dementia in five domains related to financial behavior: Trust, Susceptibility to Scams, Behavioral Tendencies, Financial Management and Use of Money. Results: bvFTD showed alterations in all domains explored and was the only group prone to scams. AD and svPPA showed a greater tendency to trust people, exhibit certain behavioral tendencies, and engage in financial mismanagement, but no increased susceptibility to scams. LBD showed deficits in financial management and use of money, with preserved trust and no susceptibility to scams. Conclusion: The presence of specific profiles regarding financial behavior in different forms of degenerative dementia may be useful to creating tailored protection strategies in clinical settings.