Independent Effect of Depression on Financial Capacity in Older Adults

About This Grant

Financial capacity (FC) refers to the ability to complete a variety of everyday financial tasks and avoid financial exploitation or deception. The risk for diminished FC increases with age, is detrimental to both physical and mental health, and is associated with staggering financial costs. The early identification of seniors vulnerable to diminished FC is imperative in order to address this public health crisis threatening older adults. Importantly, compelling evidence suggests that older adults with major depression, also known as late life depression (LLD), are at significantly increased risk of diminished FC. However, this increased risk, and factors contributing to increased risk, has been understudied. Further, assessment of FC has previously required clinician administered evaluations, most existing studies of FC in LLD have been limited to relatively small samples which are not nationally representative, and have not allowed for investigation into the characteristics of LLD that contribute to diminished FC. In addition, the study of FC impairment in LLD has been challenging due to the high rate of comorbidity with MCI in this patient population. We propose the first comprehensive study in LLD to test a conceptual framework for this increased risk for diminished FC. We propose a conceptual model – the Mood, Motivation and Social Cognition Model of Diminished FC in LLD – and evaluate the validity of this model in a large nationally representative sample sufficient to test our hypotheses. We hypothesize that specific behavioral features of LLD (e.g., sadness, anhedonia, loneliness) detrimentally impact both the knowledge and abilities necessary to complete financial tasks and the ability to avoid susceptibility to deception. To accomplish our objectives, we will employ two novel ecologically valid electronic measures of FC (measured with the electronic financial capacity instrument or eFCI-SF) and susceptibility to financial deception (measured with phishing simulation) through the Brain Health Registry (BHR), a national online research registry that administers health questionnaire data every 6-months to over 60,000 older adults. We will enroll a national sample of 1,000 LLD and 1,000 non-depressed seniors into this study to complete online measures including the eFCI-SF as well as measures of financial history, mood, cognition, medical history, and socioeconomic status. In this large sample we will evaluate: 1) differences in FC between LLD and non-depressed (ND) seniors, and 2) the association between change in depression and change in FC over two years with depression and FC measured at six-month intervals. A subsample (n=300; 150 LLD and 150 non-depressed seniors) will complete a remote administered clinical assessment of neuropsychological and psychiatric functioning to validate the diagnoses (LLD and MCI) used in the large sample. These individuals will also complete the novel phishing simulation task. Completion of this study will inform the early identification of seniors at high risk for diminished FC and financial victimization which is necessary for the development of improved prevention and intervention strategies for loss of FC in older adults.