# Health and Financial Implications of Early-Stage Alzheimer's Disease and Related Dementias

> **NIH NIH RF1** · JOHNS HOPKINS UNIVERSITY · 2020 · $19,158

## Abstract

Project Summary/Abstract
 Alzheimer's Disease and Related Dementias (ADRD) are chronic, disabling cognitive impairments that
will affect an estimated 12 million Americans by 2050. Undetected, these changes can lead to financial losses
from elder abuse and fraud, forgetting to pay bills, and compromised financial decision-making. Often,
cognitive impairment is not discovered until after patients have lost significant sums of money and experienced
additional functional decline. One possible solution is to recognize the early signs of ADRD in financial data.
In pilot data (R21AG053698), we linked 20 years of Medicare claims to quarterly credit reports, demonstrating
that ADRD patients without a spouse/partner are more likely to miss bill payments, develop subprime credit,
and experience adverse financial events for years prior to their diagnosis, a pattern unique to ADRD.
 Our prior work suggests that banking and credit data can be used to screen for dementia in the clinical
setting, and to protect patients and families from ADRD-linked financial exploitation and other losses, including
health effects of dealing with additional financial stress. We propose to test these hypotheses in the following
aims, using newly created financial data linkages and partnering with patients, government, and industry: Aim
1: Test whether and when unique financial symptoms of ADRD are present in credit data prior to clinical
diagnosis in coupled households. Aim 2: Test whether unique financial symptoms of ADRD can be observed
in banking and brokerage data before accountholders experience elder mistreatment, fraud, and diminished
capacity. Aim 3: Compare 4-year rates of mortality and hospitalization among spouses of ADRD patients with
and without adverse credit events by the time of diagnosis. Aim 4: Assess the feasibility and ethical
implications of using financial data to detect ADRD.
 We will use a 20-year panel of Medicare claims linked to consumer credit reports for Aims 1 and 3 and
more than 10 years of account information from a large US bank in Aim 2. We will compare ADRD to other
health conditions and sources of elder mistreatment to determine whether it has a unique financial
presentation.
 Our study team includes an interdisciplinary group of physicians, economists, ethicists, and health
services researchers with a long history of collaboration in partnership with the Federal Reserve, patient and
industry stakeholders. Findings from this study will provide the most comprehensive information to date on the
prevalence and magnitude of financial losses and elder mistreatment prior to ADRD diagnosis, as well as their
impact on spousal health. This information is critical for many public and private decisions ranging from when
and whether to begin screening for ADRD, the potential role of financial institutions in protecting clients who
may be unaware of their early cognitive decline, and whether consumer data are sufficiently informative about
health to require...

## Key facts

- **NIH application ID:** 10096210
- **Project number:** 1RF1AG069922-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Lauren Hersch Nicholas
- **Activity code:** RF1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $19,158
- **Award type:** 1
- **Project period:** 2020-09-15 → 2020-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10096210

## Citation

> US National Institutes of Health, RePORTER application 10096210, Health and Financial Implications of Early-Stage Alzheimer's Disease and Related Dementias (1RF1AG069922-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10096210. Licensed CC0.

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