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Lichtenberg PA, Tarraf W, Rorai VO, Roling M, Moray J, Gross EZ, Boyle PA. The WALLET Study: Examining early memory loss and personal finance. Innov Aging 2022; 6:igac038. [PMID: 35795136 PMCID: PMC9250658 DOI: 10.1093/geroni/igac038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Indexed: 11/27/2022] Open
Abstract
Background and Objectives This feasibility study tests a new approach for assessing personal finance in older persons with early memory loss. The project examines 2 primary outcomes that gauge the financial viability and well-being of older adults: wealth loss and financial exploitation. The overall objective is to determine the association of financial literacy and management, financial decision-making, and cognition with wealth loss and financial exploitation. Research Design and Methods This cross-sectional study recruited 46 participants who were 60 years of age or older. Participants were classified as having mild cognitive impairment, perceived cognitive impairment, or no cognitive impairment. The study coordinator arranged with each participant to obtain copies of their main checking account statements for 12 consecutive months within the previous 2 years and, if appropriate, credit card statements. All statements were de-identified and assigned a random ID number. Participants then completed 2 telephone interviews. Results The average participant age was 72 years (standard deviation [SD] = 7.7); 84% were female, 39% White, and 35% currently married. Average education was 16.2 years (SD = 2.4); mean yearly household income was almost $42,000 (SD = 25,752); and monthly social security payments averaged $1,446 (SD = 1,244). Our results indicate that the methods used to analyze checking account statements, followed by telephone interviews to verify identified trends, were useful in developing a financial behavior index to measure wealth loss. Discussion and Implications We demonstrate an alternative method for assessing personal finance using person-centered principles, which we believe are critical in the presence of diminished or impaired cognition. Our findings offer an innovative method for assessing the risk for wealth loss and financial exploitation.
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Affiliation(s)
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit , Michigan, USA
- Department of Healthcare Sciences, Wayne State University, Detroit , Michigan, USA
| | - Vanessa O Rorai
- Institute of Gerontology, Wayne State University, Detroit , Michigan, USA
| | - Matthew Roling
- School of Business, Wayne State University, Detroit , Michigan, USA
| | - Juno Moray
- Institute of Gerontology, Wayne State University, Detroit , Michigan, USA
| | - Evan Z Gross
- Rehabilitation Institute of Michigan, Detroit , Michigan, USA
| | - Patricia A Boyle
- Rush Alzheimer Disease Center, Rush University Medical Center, Chicago , Illinois, USA
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Lichtenberg PA, Campbell R, Hall L, Gross EZ. Context Matters: Financial, Psychological, and Relationship Insecurity Around Personal Finance Is Associated With Financial Exploitation. Gerontologist 2021; 60:1040-1049. [PMID: 32211847 DOI: 10.1093/geront/gnaa020] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Context can influence or overwhelm the intellectual and cognitive aspects of financial decision making but has only recently received increased attention. The construct validity of conceptual subscales from a financial decision-making scale was examined in the context of their relationship to financial exploitation. RESEARCH DESIGN AND METHODS Two hundred forty-two community-based participants were recruited into the study. The final sample contained 242 participants. Measures included demographic variables, conceptually derived contextual items, and neurocognitive measures. Seventeen of the 34 contextual items investigated differentiated financially exploited and nonexploited older adults. Combining these 17 contextual items led to the creation of a new scale: the Financial Exploitation Vulnerability Scale (FEVS). Correlational analyses and area under the curve analyses were used to examine the relationship between this new scale of contextual items and other measures and to determine how clinically meaningful the scale was in the current sample. RESULTS Contextual items were powerful discriminators between those who were exploited and those who were not. The new scale of contextual items (the FEVS) demonstrated good internal consistency (Cronbach's alpha = 0.82) and a strong area under the curve (receiver operating characteristic = 0.80), thereby indicating good clinical significance and evidence for construct validity. DISCUSSION AND IMPLICATIONS We examined the conceptually derived subscales of financial awareness, psychological vulnerability, and relationship strain and how these relate to financial exploitation. Our major finding is that contextual items differentiated between exploited and nonexploited adults, which demonstrate the importance of measuring context in financial decision making and exploitation. A new scale for measuring contextual items was introduced.
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Affiliation(s)
- Peter A Lichtenberg
- Department of Psychology, Institute of Gerontology, Wayne State University, Detroit, Michigan
| | - Rebecca Campbell
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, Michigan
| | - LaToya Hall
- Department of Psychology, Institute of Gerontology, Wayne State University, Detroit, Michigan
| | - Evan Z Gross
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, Michigan
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Norman AL, Woodard JL, Calamari JE, Gross EZ, Pontarelli N, Socha J, DeJong B, Armstrong K. The fear of Alzheimer's disease: mediating effects of anxiety on subjective memory complaints. Aging Ment Health 2020; 24:308-314. [PMID: 30411628 DOI: 10.1080/13607863.2018.1534081] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: To determine if the fear of developing Alzheimer's disease (FDAD) construct, in combination with similar psychoemotional factors, could help elucidate the nature of older adults' subjective memory complaints (SMCs) and subsequent objective memory performance.Methods: One hundred ninety-three healthy older adults (aged 65-93) were administered clinician and self-report measures of depression, worry, anxiety, illness attitudes, and memory, and each rated their concern with developing AD.Results: Self-reported FDAD was not associated with objective memory performance (p > .05). FDAD, trait anxiety, general anxiety, and general and illness-related worry were independently associated with subjective memory report (ps < .05). The relationship between FDAD and subjective memory report was mediated by measures of general trait and state anxiety, but not general worry or illness-specific worry.Conclusions: FDAD was not associated with objective memory functioning, suggesting AD concerns were not reflective of memory pathology. The mediating effect of anxiety on the relationship between FDAD and subjective memory report suggests that assessment of anxiety, beyond AD fear, may help identify older adults at risk for developing negative perceptions of memory and related distress.
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Affiliation(s)
- Andria L Norman
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - John L Woodard
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - John E Calamari
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Evan Z Gross
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Noelle Pontarelli
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Jami Socha
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Brandon DeJong
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Kerri Armstrong
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
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Gross EZ, Campbell RJ, Hall L, Lichtenberg P. FINANCIAL DECISION MAKING SELF-EFFICACY IN COGNITIVELY AND FINANCIALLY VULNERABLE OLDER ADULTS. Innov Aging 2019. [PMCID: PMC6840316 DOI: 10.1093/geroni/igz038.1778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Financial decision making self-efficacy (FDMSE) is a novel construct that may influence how older adults make financial decisions. Our previous research with a community sample of older adults demonstrated that cognitive functioning and suspected history of financial exploitation were both associated with low FDMSE. We sought to replicate these findings in two clinical samples of older adults: people with mild cognitive impairment (MCI) or probable Alzheimer’s disease (PAD) and current victims of scams or exploitation as determined by a financial coach. Samples were obtained from the Michigan Alzheimer’s Disease Center and a financial coaching intervention study. All participants completed a 4-item FDMSE measure. One-way ANOVAs, t-tests and chi-square tests were conducted to test for group differences with controls on demographics. There was a main effect of cognitive status on FDMSE, F(2,138) = 8.10, p < .001, which was driven by higher FDMSE in the healthy group (N = 63) than the MCI (N = 76) or PAD (N = 28) groups. Similarly, scam victims (N = 25) had significantly lower FDMSE than non-exploited (N = 25) peers, t(48)=2.33, p < 05. Cognitive impairment and current financial scams are both associated with low FDMSE levels. Low FDMSE may exacerbate cognitive and psychosocial vulnerabilities that contribute to risk for poor financial decisions among older adults. Future interventions to enhance FDMSE may help older adults make better decisions despite changes in thinking abilities or previous negative financial experiences.
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Affiliation(s)
- Evan Z Gross
- Wayne State University, Detroit, Michigan, United States
| | | | - LaToya Hall
- Wayne State University, Detroit, Michigan, United States
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Ryals AJ, Rogers LM, Gross EZ, Polnaszek KL, Voss JL. Associative Recognition Memory Awareness Improved by Theta-Burst Stimulation of Frontopolar Cortex. Cereb Cortex 2016; 26:1200-1210. [PMID: 25577574 PMCID: PMC4737609 DOI: 10.1093/cercor/bhu311] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Neuroimaging and lesion studies have implicated specific prefrontal cortex locations in subjective memory awareness. Based on this evidence, a rostrocaudal organization has been proposed whereby increasingly anterior prefrontal regions are increasingly involved in memory awareness. We used theta-burst transcranial magnetic stimulation (TBS) to temporarily modulate dorsolateral versus frontopolar prefrontal cortex to test for distinct causal roles in memory awareness. In three sessions, participants received TBS bilaterally to frontopolar cortex, dorsolateral prefrontal cortex, or a control location prior to performing an associative-recognition task involving judgments of memory awareness. Objective memory performance (i.e., accuracy) did not differ based on stimulation location. In contrast, frontopolar stimulation significantly influenced several measures of memory awareness. During study, judgments of learning were more accurate such that lower ratings were given to items that were subsequently forgotten selectively following frontopolar TBS. Confidence ratings during test were also higher for correct trials following frontopolar TBS. Finally, trial-by-trial correspondence between overt performance and subjective awareness during study demonstrated a linear increase across control, dorsolateral, and frontopolar TBS locations, supporting a rostrocaudal hierarchy of prefrontal contributions to memory awareness. These findings indicate that frontopolar cortex contributes causally to memory awareness, which was improved selectively by anatomically targeted TBS.
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Affiliation(s)
- Anthony J. Ryals
- Department of Medical Social Sciences, Ken & Ruth Davee Department of Neurology, Interdepartmental Neuroscience Program, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lynn M. Rogers
- Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, USA
| | - Evan Z. Gross
- Department of Medical Social Sciences, Ken & Ruth Davee Department of Neurology, Interdepartmental Neuroscience Program, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kelly L. Polnaszek
- Department of Medical Social Sciences, Ken & Ruth Davee Department of Neurology, Interdepartmental Neuroscience Program, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Joel L. Voss
- Department of Medical Social Sciences, Ken & Ruth Davee Department of Neurology, Interdepartmental Neuroscience Program, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Wang JX, Rogers LM, Gross EZ, Ryals AJ, Dokucu ME, Brandstatt KL, Hermiller MS, Voss JL. Targeted enhancement of cortical-hippocampal brain networks and associative memory. Science 2014; 345:1054-7. [PMID: 25170153 DOI: 10.1126/science.1252900] [Citation(s) in RCA: 348] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The influential notion that the hippocampus supports associative memory by interacting with functionally distinct and distributed brain regions has not been directly tested in humans. We therefore used targeted noninvasive electromagnetic stimulation to modulate human cortical-hippocampal networks and tested effects of this manipulation on memory. Multiple-session stimulation increased functional connectivity among distributed cortical-hippocampal network regions and concomitantly improved associative memory performance. These alterations involved localized long-term plasticity because increases were highly selective to the targeted brain regions, and enhancements of connectivity and associative memory persisted for ~24 hours after stimulation. Targeted cortical-hippocampal networks can thus be enhanced noninvasively, demonstrating their role in associative memory.
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Affiliation(s)
- Jane X Wang
- Department of Medical Social Sciences, Ken and Ruth Davee Department of Neurology, and Interdepartmental Neuroscience Program, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Lynn M Rogers
- The Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, USA
| | - Evan Z Gross
- Department of Medical Social Sciences, Ken and Ruth Davee Department of Neurology, and Interdepartmental Neuroscience Program, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Anthony J Ryals
- Department of Medical Social Sciences, Ken and Ruth Davee Department of Neurology, and Interdepartmental Neuroscience Program, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mehmet E Dokucu
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kelly L Brandstatt
- Department of Medical Social Sciences, Ken and Ruth Davee Department of Neurology, and Interdepartmental Neuroscience Program, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Molly S Hermiller
- Department of Medical Social Sciences, Ken and Ruth Davee Department of Neurology, and Interdepartmental Neuroscience Program, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Joel L Voss
- Department of Medical Social Sciences, Ken and Ruth Davee Department of Neurology, and Interdepartmental Neuroscience Program, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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