Browsing by Subject "Scam"

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    Association of Amyloid-β Pathology with Decision Making and Scam Susceptibility
    (IOS Press, 2021) Kapasi, Alifiya; Yu, Lei; Stewart, Christopher; Schneider, Julie A.; Bennett, David A.; Boyle, Patricia A.; Neurology, School of Medicine
    Background: Recent findings suggest that poor decision making and increased scam susceptibility are harbingers of Alzheimer's disease (AD) dementia and may be among the earliest behavioral manifestations of pathologic cognitive aging. However, the degree to which poor decision making and scam susceptibility reflect accumulating Alzheimer's disease (AD) pathology remains unclear. Objective: To investigate the associations of AD pathology with decision making and scam susceptibility in older adults without dementia. Methods: Data came from 198 deceased participants without clinical dementia (mean age at death = 90 years; 69%women) from two ongoing studies of aging. All underwent annual clinical evaluations, completed assessments of healthcare and financial decision making and scam susceptibility, and brain donation. Neuropathologic evaluations quantified pathologic hallmarks of AD, amyloid-β and tau-tangles, Lewy body pathology, and TDP-43 proteinopathy. Results: In linear regression models adjusted for demographics, amyloid-β pathology was associated with lower decision making (estimate = -0.35; SE = 0.16, p = 0.03), particularly healthcare decision making (estimate = -0.20; SE = 0.09, p = 0.03), as well as greater scam susceptibility (estimate = 0.12; SE = 0.04, p = 0.003); tau-tangle pathology was not related. Further, TDP-43 pathology was associated with greater scam susceptibility (estimate = 0.10; SE = 0.04; p = 0.02). Conclusion: Accumulating AD pathology, particularly amyloid-β, is associated with poor decision making and increased scam susceptibility among older persons without overt cognitive impairment. These findings provide compelling evidence that decision making and scam susceptibility are sensitive to the earliest pathological changes of AD.
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    Scam susceptibility is associated with a markedly accelerated onset of Alzheimer's disease dementia
    (Wiley, 2025) Boyle, Patricia A.; Wang, Tianhao; Mottola, Gary; Stewart, Chris; Wilson, Robert S.; Bennett, David A.; Yu, Lei; Neurology, School of Medicine
    Introduction: The association of scam susceptibility with the timing of Alzheimer's disease (AD) dementia onset is unknown. Methods: One thousand ninety-two older adults without dementia underwent assessments of scam susceptibility and annual clinical evaluations to document incident AD dementia. Accelerated failure time models examined the relation of scam susceptibility with dementia onset. Results: During a mean of 5 years of follow-up (standard deviation = 3.1), 188 individuals (17%) were diagnosed with incident AD dementia. A higher level of scam susceptibility was associated with a considerably earlier dementia onset ( β = -0.039; 95% confidence interval: -0.061, -0.017); those with a high level of susceptibility developed AD dementia at a mean age of 90.9 years compared to 98.2 for those with a low level. Results persisted after controlling for global cognition, sex, and education. Discussion: Scam susceptibility is associated with a markedly earlier onset of AD dementia. Assessment of susceptibility may facilitate early identification of individuals at risk of developing dementia. Highlights: We examined whether scam susceptibility among older adults is associated with an accelerated onset of Alzheimer's disease dementia. Participants came from a large ongoing cohort study of aging. Scam susceptibility was assessed using a validated measure. Scam susceptibility was associated with a marked acceleration in dementia onset. Assessment of susceptibility may facilitate early identification of dementia.