Late payments, credit score may predict dementia

Years before the diagnosis of dementia, retrospective data showed that bill payment and personal financial management issues became apparent.

Six years before being diagnosed with dementia, people with dementia associated with Alzheimer’s disease were more likely to miss credit account payments than people without dementia (7.7% vs. 7.3%; absolute difference). 0.4 percentage points, 95% CI 0.07-0.70), reported by Dr. Lauren Harsh Nicholas, MPP, and co-authors of Johns Hopkins University in Baltimore.

They were also likely to develop a subprime credit score 2.5 years before the diagnosis of dementia (8.5% vs. 8.1%; absolute difference 0.38 percentage points, 95% CI 0.04-0.72), researchers said. Are writing. JAMA Internal Medicine..

After the diagnosis of dementia, higher delinquency rates and subprime mortgage rates lasted for at least 3.5 years.

“Our study uses administrative financial records to provide the first large-scale evidence of financial symptoms of Alzheimer’s disease and related dementia,” said Nicholas.

“These results are important because they highlight new data sources (consumer credit reports) that can help detect early signs of Alzheimer’s disease,” she said. Today’s MedPage.. “Physicians have long believed that dementia is on the checkbook, but our study shows that these economic symptoms are common and span years before and after diagnosis. , Suggesting an unmet need for support in managing money. “

Irregular bill payments, dangerous financial decisions, and susceptibility to fraud are widely recognized as early signs of dementia. In recent studies Low awareness of fraud Predicted accidental cognitive impairment. It suggests that changes in judgment can occur years before the loss of memory and thinking becomes apparent.

In their study, Nicholas and colleagues linked the results of the 1999-2018 Consumer Credit Report to billing data for 81,364 Medicare recipients living in single-person households.Researchers used the Federal Reserve Bank of New York’s Equifax Consumer Credit Panel data To look for two indicators of poor financial management: delinquent payments (30 days or more late) and subprime credit score (620 or less) Equifax risk score, This is a summary of the predicted risk of loan defaults over the next 24 months based on credit history).

In total, 27,302 Medicare recipients in this study were diagnosed with dementia between 1999 and 2014 (mean age 79 years, about 69% were women), and 54,062 did not. (The average age was 74 years and 67% were women). Dementia was defined by the diagnostic code for Alzheimer’s disease and related dementia. A single beneficiary household was selected so that the link between dementia diagnosis and financial outcomes was not obscured by a cognitively normal spouse.

The association between delinquency and dementia accounted for 5.2% of delinquency 6 years before diagnosis and 17.9% of delinquency 9 months after diagnosis. By the quarter after diagnosis, people with dementia were more likely to miss payments (7.9% vs. 6.9%) and were more likely to have a subprime credit score than people without dementia. (8.2% vs 7.5%). Patterns of adverse economic events associated with the diagnosis of dementia were not found in other medical conditions such as arthritis, glaucoma, and hip fractures.

Increased delinquency and subprime credit score rates were more common among single Medicare beneficiaries in less educated census districts. For people with low-education dementia, the delinquency rate was high almost seven years before diagnosis. For people in higher education, an increase in rates was apparent 2.5 years before the diagnosis.

The consumer credit industry is effectively making money from Alzheimer’s disease and dementia, said Jason Carrawish, MD, MD, University of Pennsylvania, Philadelphia. Ancillary editorial..

Karlawish pointed out that about 80% of delinquent credit payments in the survey missed credit card bill payments. “Credit card companies have statutory protections that charge breathtaking fees and interest rates on late payments and outstanding balances, respectively,” he wrote.

But he pointed out that it doesn’t have to be that way. “There is no reason why artificial intelligence can’t learn from financial transactions and smart devices that their natural users, you and humans like me, aren’t as smart as we used. Manage money and traffic. It also describes how we are doing other cognitively demanding real-world actions, such as using technologies such as institutions, stoves, smartphones, remote controls, and computers. “

“This approach can have a significant impact on the well-being of our individuals and our people,” he added. “Cognitive deficits cause wealth loss, and wealth is one of the social determinants of health and illness.”

Nicholas and co-authors said the study had some limitations. Only Medicare beneficiaries claiming to have a diagnostic code for Alzheimer’s disease and associated dementia were considered to have dementia. People who were diagnosed with dementia outside the Medicare system (for example, a veterans’ clinic) may not have been included. Only paid Medicare recipients were investigated. Delinquent payments were limited to debt reported to credit bureaus, excluding utilities, rent, and medical collection accounts.