Mid-Career Development and Mentoring on Financial Vulnerability and Alzheimer's Disease

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PROJECT SUMMARY/ABSTRACT Understanding financial exploitation among older adults is an important public health issue; however, the reasons why some older adults may be more susceptible to fraud are poorly understood. To address this, I have developed a program of research focused on understanding the diverse behavioral, contextual, and neurobiological factors that impact financial decision making and financial exploitation vulnerability in older age. This program of research leverages extramurally-funded USC-based resources and collaborative endeavors with the Rush Alzheimer’s Disease Center (RADC), which together provide trainees the opportunity to work with diverse datasets and research mentors. Age-related decline in cognitive abilities impacting financial decision making is believed to be a central risk factor for fraud in older age. Those with Alzheimer’s Disease and Related Dementias (ADRD) and Mild Cognitive Impairment (MCI) are believed to be most at risk for financial exploitation. However, most of this research is based either on indirect or anecdotal evidence. Relatedly, cognitive symptom profiles of those with ADRD who experience scam and fraud are unknown. Neuroimaging work has implicated the structure and connectivity of specific brain regions as neurobiological mechanisms; however, these have yet to be implicated in ADRD patients specifically. Importantly, since factors associated with Alzheimer’s Disease are known to differ by race, and rates of financial fraud appear to differ according to race, an understanding of these differences is a scientifically crucial. To address these questions, the research project for this K24 Career Development Award proposes to expand the current program of research by investigating the associations between financial fraud and ADRD in the Health and Retirement Study (HRS) and the Rush Alzheimer’s Disease Center (RADC) cohorts. The HRS is considered the largest and most nationally-representative study of aging in the United States. In 2016, the HRS initiated Module 2, which introduced financial fraud items into the survey. Since 2013, the RADC has collected financial decision making and neuroimaging data as an integrated part of their large, community-based, neuroepidemiologic studies of aging, and I have been an active collaborator on many of these studies. A proposed mentoring team consisting of USC and RADC faculty will provide me and my mentees guidance in mentorship, professional development, and current research approaches in the HRS and RADC cohorts. Finally, because financial vulnerability in non-demented older adults has recently been associated with greater risk for Alzheimer’s Disease in longitudinal models, we secondarily aim to explore the association of preclinical Alzheimer’s Disease blood-based biomarkers with financial exploitation risk in a subset of local older adults without cognitive impairment. This mid-career award will address financial vulnerability considerations in ADRD.