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Psychological and Functional Vulnerability Predicts Fraud Cases in Older Adults: Results of a Longitudinal Study
Abstract and Figures
Using cross sectional data Psychological vulnerability was identified as a correlate of older adult’s being defrauded. We extend that research by examining fraud prevalence using longitudinal data from the Health and Retirement Study, and to identify the best predictors of fraud longitudinally across a 4-year time frame. Whereas reported fraud prevalence was 5.0% in a 5-year look-back period in 2008, it increased to 6.1% in 2012. The rate of new-incident fraud across only a 4-year look-back was 4.3%. Being younger-old, having a higher level of education, and having more depression significantly predicted the new cases of fraud reported in 2012. Psychological vulnerability was a potent longitudinal predictor of fraud, with the most vulnerable individuals being more than twice as likely to be defrauded. Results indicate that fraud victimization among older adults is rising, and that vulnerability variables, along with some demographic variables, predict new cases of fraud.
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... Studies vary about determining the age of "older adults" when it comes to victimization. Some employed 50 (Lichtenberg et al., 2013(Lichtenberg et al., , 2016, 55 (Pak & Shadel, 2011;Federal Trade Commission, 2003), 60 (Reisig & Holtfreter, 2013;Holtfreter et al., 2014), and 65 (Burnes et al., 2017;DeLiema, 2018;Fenge & Lee, 2018;Harrell, 2015;Anderson, 2004Anderson, , 2007Anderson, , 2013Harrell & Langton, 2013;Holtfreter et al., 2006;AARP, 1999;Titus et al., 1995) years of age. We applied the age of 55 as a dividend between "younger" and "older" adults since people over 55 have not yet had computers and the internet as part of their everyday lives while growing up (Parker & Davey, 2014;Molnar, 1997). ...
... First and foremost, the cross-sectional nature of this study precludes us from establishing a causal connection between the study variables. While the study model was based on studies which demonstrated causal links between sociodemographic (e.g., education) and psychological (e.g., depression) factors and financial fraud (e.g., Lichtenberg et al., 2016), the causal associations between the study variables need to be examined in future studies. In this context, it should also be noted that the study was comprised of a convenience sample of older adults who responded to questionnaires online. ...
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.
... This indicates that in the past three months, the higher the frequency of dining out, the lower the sense of safety score of elderly people. Previous studies have shown that in terms of public social issues, the problem of elderly people being deceived is particularly severe [52,53]. Elderly people dining out may invite fraud incidents, which may cause economic losses and serious trauma to the elderly [54][55][56]. ...
Against the backdrop of accelerating population aging and scarce elderly care resources and facilities in China, the issue of the sense of safety among the elderly has received widespread attention. This article is based on data from the China Labor Force Dynamics Survey (CLDS) in 2016 and takes three major urban agglomerations as examples to examine the impact mechanisms of urban built environments on elderly people’s sense of safety. The results indicate that the characteristics of the urban built environment, the social environment, and individual health affect the safety perceptions of the elderly. Among them, urbanization rate, hospital facilities, population density, greening rate, air quality, and frequency of dining out have significant impacts on elderly people’s sense of safety. Simultaneously, good daily exercise and mental health status can significantly improve elderly people’s sense of safety. This article summarizes the existing problems of aging-friendly spaces and facilities in three major urban agglomerations, proposes planning strategies to enhance elderly people’s sense of safety, and provides a useful reference for urban aging-friendly transformations and an elderly-friendly society.
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.
Poor financial and health literacy and poor psychological well-being are significant correlates of scam susceptibility in older adults; yet, no research has examined whether interventions that target these factors may effectively reduce susceptibility. Using longitudinal data from older adults in the Rush Memory and Aging Project (MAP) ( N = 1,231), we used microsimulations to estimate the causal effect of hypothetical well-being and literacy interventions on scam susceptibility over six years. Microsimulations can simulate a randomized trial to estimate intervention effects using observational data. We simulated hypotheticalinterventions that improved well-being or literacy scores by either 10% or 30% from baseline, or to the maximum scores, for an older adult population and for income and education subgroups. Simulations suggest thathypotheticalinterventions that increase well-being or literacy cause statistically significant reductions in scam susceptibility of older adults over time, but improving well-being caused a greater—albeit not significantly different—reduction compared to improving literacy.
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.
Older adults increasingly adopt the Internet for general daily activities that improve their quality of life. At the same time, media reports and public safety campaigns are raising awareness of increases in digitally mediated scams that target this demographic. Without reliable access to information and support to manage risks, cybersecurity threats (actual or perceived) may consequently affect how older adults engage with essential online services such as online banking, e-health, or shopping, as well as further increase their vulnerability. We present an in-depth qualitative investigation aimed at uncovering how older adults’ perceptions of and attitudes toward online threats, online safety behaviours, and risk mitigation strategies affect their willingness to adopt essential services involving financial transactions or personal information. We reflect on the consequences that these attitudes, strategies, and safety-related practices have for the age-inclusive design of online services such as banking or shopping.KeywordsOlder AdultsOnline SafetyPrivacyInterfaces
Financial exploitation and financial capacity issues often overlap when a gerontologist assesses whether an older adult’s financial decision is an autonomous, capable choice. Our goal is to describe a new conceptual model for assessing financial decisions using principles of person-centered approaches and to introduce a new instrument, the Lichtenberg Financial Decision Rating Scale (LFDRS). We created a conceptual model, convened meetings of experts from various disciplines to critique the model and provide input on content and structure, and select final items. We then videotaped administration of the LFDRS to five older adults and had 10 experts provide independent ratings. The LFDRS demonstrated good to excellent inter-rater agreement. The LFDRS is a new tool that allows gerontologists to systematically gather information about a specific financial decision and the decisional abilities in question.
This study examined correlates of susceptibility to scams in 639 community-dwelling older adults without dementia from a cohort study of aging. Regression models adjusted for age, sex, education, and income were used to examine associations between susceptibility to scams, measured by a five-item self-report measure, and a number of potential correlates. Susceptibility was positively associated with age and negatively associated with income, cognition, psychological well-being, social support, and literacy. Fully adjusted models indicated that older age and lower levels of cognitive function, decreased psychological well-being, and lower literacy in particular may be markers of susceptibility to financial victimization in old age.
Financial exploitation, and particularly thefts and scams, are increasing at an alarming rate. In this study we (a) determined the national prevalence of older adults who report having been a victim of fraud, (b) created a population-based model for the prediction of fraud, and (c) examined how fraud is experienced by the most psychologically vulnerable older adults. The older adults studied were 4,400 participants in a Health and Retirement Study substudy, the 2008 Leave Behind Questionnaire. The prevalence of fraud across the previous 5 years was 4.5%. Among measures collected in 2002, age, education, and depression were significant predictors of fraud. Financial satisfaction and social-needs fulfillment were measured in 2008 and were significantly related to fraud above and beyond the 2002 predictors. Using depression and social-needs fulfillment to determine the most psychologically vulnerable older adults, we found that fraud prevalence was three times higher (14%) among those with the highest depression and the lowest social-needs fulfillment than among the rest of the sample (4.1%; χ (2) = 20.49; p < .001). Clinical gerontologists and other professionals in the field need to be aware of their psychologically vulnerable clients heightened exposure to financial fraud.
We report on the development of a new cognitive screening test administered over the telephone. The Telephone Interview for Cognitive Status correlates very highly with the Mini-Mental State Examination in Alzheimer's disease. It has high sensitivity and specificity to the diagnosis of Alzheimer's disease (AD) and high test-retest reliability in this population. The instrument is acceptable to patients and has a sufficient range to be useful in follow-up and field research studies of AD and possibly other disorders associated with cognitive impairment.
(C) Lippincott-Raven Publishers.
Decision making is an important determinant of health and well-being across the lifespan but is critical in aging, when many influential decisions are made just as cognitive function declines. Increasing evidence suggests that older adults, even those without dementia, often make poor decisions and are selectively vulnerable to scams. To date, however, the factors associated with poor decision making in old age are unknown. The objective of this study was to test the hypothesis that poor decision making is a consequence of cognitive decline among older persons without Alzheimer's disease or mild cognitive impairment.Participants were 420 non-demented persons from the Memory and Aging Project, a longitudinal, clinical-pathologic cohort study of aging in the Chicago metropolitan area. All underwent repeated cognitive evaluations and subsequently completed assessments of decision making and susceptibility to scams. Decision making was measured using 12 items from a previously established performance-based measure and a self-report measure of susceptibility to scams.Cognitive function data were collected over an average of 5.5 years prior to the decision making assessment. Regression analyses were used to examine whether the prior rate of cognitive decline predicted the level of decision making and susceptibility to scams; analyses controlled for age, sex, education, and starting level of cognition. Among 420 persons without dementia, more rapid cognitive decline predicted poorer decision making and increased susceptibility to scams (p's
Recent reviews of scientific work on subjective well-being (SWB) reveal disagreements in conceptualization, measurement, and explanation of the concept. We propose Social Production Function theory as a framework to resolve them. Social Production Function (SPF) theory integrates strengths of relevant psychological theories and economic consumer/household production theories, without their limitations (namely, tradeoffs between satisfaction of different needs are not in the first, and goals or needs are not in the second). SPF theory identifies two ultimate goals that all humans seek to optimize (physical well-being and social well-being) and five instrumental goals by which they are achieved (stimulation, comfort, status, behavioural confirmation, affection). The core notion of SPF theory is that people choose and substitute instrumental goals so as to optimize the production of their well-being, subject to constraints in available means of production. SPF theory guides research measurement and explanatory models, and it integrates features of contemporary subjective well-being theories.
What are the dimensions of well-being? That is, what universal goals need to be realized by individuals in order to enhance their well-being? Social production function (SPF) theory asserts that the universal goals affection, behavioral confirmation, status, comfort and stimulation are the relevant dimensions of subjective well-being. Realization of these substantive goals and the perspective on opportunities to realize these goals in the future contributes to the affective and cognitive component of well-being. The theoretical elaboration of this theory has been published elsewhere. This paper provides a measurement instrument for the dimensions of well-being. To measure levels of affection, behavioral confirmation, status, comfort and stimulation, and empirically validate the dimensions of well-being, the SPF-IL scale was developed. This paper presents findings from a pilot study (n =145), the main study (n = 1094), a test–retest examination (n = 163), and a validation study (n = 725). The measurement model was tested by means of structural equation modeling. Confirmatory factor analysis supported the dimensional structure of well-being, indicating construct validity. The overall fit of the model was sufficient, in spite of the somewhat problematic measurement of status, and the test–retest study showed an acceptable level of stability. As for the content validity of the dimensions and their measurement, various sub-studies showed that the SPF-IL scale is a valid instrument, doing at least as well as popular measures of overall well-being but also specifying its dimensions.
The Telephone Interview for Cognitive Status (TICS) is an 11-item screening test (maximum score=41 points) that was developed for the assessment of cognitive function in patients with Alzheimer's disease who are unwilling or unable to be examined in person. To investigate the 1-month test-retest reliablility and validity of the TICS in a stroke sample, we administered it twice by telephone to 36 stroke patients (age = 72.3 ± 8.9; education = 9.7 ± 4.7) and 36 stroke-free non-demented control subjects (age = 71.8 ± 6.8; education = 13.1 ± 4.1). Dementia was diagnosed in six stroke patients based on neuropsychological and functional examinations performed during an outpatient visit and the Mini-Mental State Examination (MMSE) was also given. Multiple regression analyses determined that stroke status was significantly related to performance on the TICS (β= −0.26, p = 0.006), while adjusting for demographic variables. Among stroke patients, test-retest reliability was excellent (r = 0.90, p < 0.001) and performance was significantly correlated with MMSE score (r = 0.86, p <0.001). A TICS cutoff score <25 best distinguished between demented and non-demented patients; sensitivity (1.00) and specificity (0.83) were excellent and comparable to the sensitivity (0.83) and specificity (0.87) of the MMSE, with dementia defined as a score <24/30. We conclude that the TICS is a reliable mental status test that can provide accurate information regarding cognitive function in stroke patients who cannot be assessed in person.
The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The new scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test- retest repeatability. Validity was established by pat terns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of de pression.
Detection of dementia in large, geographically dispersed populations is difficult. Conventional in-person neuropsychological assessment techniques, no matter how brief, are too costly to be practical for this purpose. Telephone interviewing is an obvious alternative for cognitive screening, but its practical utility is relatively unexplored. We therefore investigated the performance characteristics of a telephone screen for dementia in elderly residents of congregate housing facilities. We interviewed 209 subjects using the Telephone Interview for Cognitive Status (TICS) and a modified version (TICS-m) that includes items sensitive to early dementia (delayed recall) and eliminates other items difficult to verify in survey work. After the subjects received a brief in-person neuropsychological assessment, TICS and TICS-m scores were compared as predictors of the resulting clinical assignment (normal, mildly impaired, or demented). Although the TICS-m yielded slightly better results, both versions of the instrument were sensitive and specific indicators of dementia in this community sample. In a separate exercise, both instruments also correctly identified 17 clinic patients with carefully diagnosed Probable AD. Telephone interviewing of cognitive function may therefore provide an economical approach to mental status screening in research studies where in-person assessment is impractical.
(C) Lippincott-Raven Publishers.