Forgetting to Pay bills may be a sign of declining cognition

This article was supplied by StepUp for Dementia Research.

In the everyday busyness of life it is easy to forget things, and when we do it is typically harmless.  However, a study published last month found that forgetting to pay your bills, specifically credit card bills, could be an early warning sign for declining cognition[1]. 

Finance and Health Data Linkage

The American-based researchers retrospectively analysed the credit report outcomes from 1999 to 2018 of 81,364 individuals on Medicare benefits who were living alone[2].  Across the study period, 27,302 of the beneficiaries received a diagnosis of dementia.  They were compared to the remaining 54,062 beneficiaries who did not receive a dementia diagnosis. The team focused on missing credits payments that were at least 30 days late, and subprime credit ratings. 

Issues as early as six years before diagnosis

The study found that Medicare beneficiaries with dementia were more likely to miss bill payments up to 6 years prior to diagnosis and developed subprime credit ratings 2.5 years prior to diagnosis, compared with those who were never diagnosed.  These negative financial outcomes persisted after the dementia diagnosis and were more common in individuals with less college education. 

Missing payments unique to dementia

To work out whether the economic symptoms observed were unique to dementia, financial outcomes were also compared to other health outcomes. The study found no association of increased missed payments or subprime credit scores prior to a diagnosis for arthritis, glaucoma, or a hip fracture. Whilst payment issues only became apparent one year prior to a heart attack.

Claims taken with caution

The study had several limitations. Firstly, it only identified beneficiaries with dementia if they had a health care claim with the diagnosis. This means that the non-dementia comparison group might have included people who had dementia but who were not formally diagnosed yet or who were diagnosed outside of the care system. Moreover, whilst limiting the sample to single-person households helped to remove any confusion of a partner possibly managing affairs, the results cannot be generalised to couples or those living in group arrangements.  Also, the study only included debts reported to credit bureaus; it did not include more common daily living utilities, rent and medical collections.

Protecting Financial Wellbeing

Nonetheless, the study findings add to evidence highlighting the need for early detection of dementia. The results also highlight the importance of protecting the financial wellbeing of people with dementia.  Implications include educating the banking sector about the increased risk of financial abuse amongst people with dementia. Dementia Australia has a helpful resource on this for those wishing to find out more[3].

If you are interested in participating in dementia research visit our website at www.stepupfordementiaresearch.org.au or speak to one of thier friendly team at 1800-STEP-123 (1800-7837-123) to find out how you can contribute to advancing dementia research.

[1] jamanetwork.com/journals/jamainternalmedicine/article-abstract/2773241

[2] To be eligible for Medicare in America, individuals must be aged 65 years and over or under 65 years with a disability and receive social security payments – www.ncpssm.org/our-issues/medicare/medicare-fast-facts/

[3] www.dementia.org.au/sites/default/files/20140618-NSW-Pub-DiscussionPaperFinancialAbuse.pdf

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