Cognitive Impairment and Susceptibility to Scams

October 31, 2022

For older adults living with dementia, cognitive impairment can lead to susceptibility to fraudulent activities. In this episode we’ll discuss with Dr. Duke Han from the Keck School of Medicine at USC what’s known about the intersection of aging, cognition, and susceptibility to scams.

Transcript

Matt Davis:

According to the Federal Bureau of Investigation, older adults lost over a billion dollars to financial scams in 2020. When considering other indirect costs of scams, estimates swell to over 3 billion in losses to the US economy. In 2020, more than 100,000 older Americans were duped by a scam at an average cost of $9,000, and more than 2000 individuals had more than $1000,000 stolen.

We now live in a world dependent on technology that has fundamentally changed how we interact with others. Just like any other American, older adults now communicate over social media and by email. They find partners online. They use web-based interfaces for banking, and managing their finances, and much more.

Older adults are known to be at particularly high risk for financial scams. According to the FBI, older Americans are the group most often targeted with the highest number of fraud cases occurring in Florida, California, and Texas. Such schemes can appear as tech fraud support, lottery or sweepstakes scams, or even romantic plots. Many older Americans are retired and are living on savings that have been accrued over a lifetime that make fallout of being victim to a scam particularly devastating.

Now, it's not a stretch to imagine that older Americans living with a cognitive limitation could be even more vulnerable to being taken advantage of by fraudsters. In this episode, we'll speak with a researcher who's been out in front of this. We'll discuss what's known about cognitive impairment and susceptibility to financial scams. I'm Matt Davis.

Donovan Maust:

I'm Donovan Maust.

Matt Davis:

You're listening to Minding Memory. Today, we're joined by Dr. Duke Han. Dr. Han is a director of neuropsychology in the Department of Family Medicine and a professor of family medicine, neurology, psychology, and gerontology at the Keck School of Medicine at the University of Southern California.

Dr. Han's research focuses on factors that affect cognition and decision-making in aging. His work has used several novel neural imaging and statistical approaches to better understand these factors. He's here today though to talk with us about some of his own research on cognitive impairment and susceptibility to financial scams. Duke, thanks so much for joining us.

Dr. Duke Han:

Great to be here. Thanks for the invitation, Matt and Donovan. I think the podcast is great, and I hope more people listen to it.

Matt Davis:

So to start things off, what are some examples of financial scams that are out there today?

Dr. Duke Han:

In your introduction, you already mentioned a few that are common. Among older adults, in particular, there are telephone scans where people will pose as IRS or federal government officials to try and steal identifying information or bank information or passwords, or have the older adult send money using gift cards or some other money transportation or money delivery service.

And so older adults also seem to be more susceptible to post mail, actual physical mail scams. These are letters that are sent to older adults in their mailbox, where they pose as a psychic or a religious cleric and try to promise some sort of outcomes for a check in return. One of the famous cases of this is Maria Duval, which made headlines because she had an enterprise that was international, and actually scammed a number of older adults. The vast majority of the people that she scammed were older adults. She was brought to justice actually. The scope of that scam... Once that came to light, that was pretty shocking.

Older adults also are susceptible to a particular scam that's referred to as the grandparent scam. This is a particularly egregious one, where someone will pose as a police officer from another country, and say their grandchild is in prison, and they need to send money right away to bail them out, or otherwise, they're going to languish in their international prison. This particular scam is one that draws upon the love of older adults for their grandchildren. It's a particularly devastating one.

As you mentioned, we right now are more dependent non the internet. We're depending on computer systems to maintain communication because of the pandemic, and so internet scans have been a huge area of fraud among older adults. Along with that, there's phishing emails, popup windows on websites that demand people enter in their personal information. Many of those things lead to ransomwares. Then the older adults have to pay money to get control back of their computer. These are just some common examples of financial scams among older adults right now.

Matt Davis:

So I was curious... When you talk about scams, the first things that come to mind are these systematic things that are targeting groups, like some of the ones you just described. Do people consider scams or fraud within families? I mean, loved ones or family members or friends kind of taking advantage as well.

Dr. Duke Han:

Yes. Yeah. We absolutely consider that. And in fact, we had a study from our laboratory recently that looked at calls to the National Center on Elder Abuse. The National Center on Elder Abuse is right across the hallway from me. They have a resource line where people can call and get information about abuse and how to address abuse. We did a study of calls to that resource line over a span of a couple years, and basically have found that scam and fraud among family members was one of the most common instances that was reported to that line.

Donovan Maust:

Is it possible to give a sense of sort of out of the universe of financial scam, I guess, perpetrated on older adults, what proportion is friends and family versus these other more, just random online targeting?

Dr. Duke Han:

So that's a great question that we don't have exact data on. Based on our individual study, that was actually the vast majority of reported scam and fraud was among family members actually. But because the scope of stranger fraud is so big, it's hard to really get a sense of a comparison between those two.

I have friends and colleagues that are actively trying to get a better handle on that, but one aspect out of this area of study, I will say, is that there's not a lot of really great data out there about it. Older adults are reluctant to report when they're scammed or frauded. There's a sense of embarrassment.

One of the things that we are trying to get out there is that very, very bright people can, unfortunately, become the victims of scam or fraud. It's not necessarily the fault of the older adult. It could be other reasons, like in the case of a family member or caregiver. Our hope is that as older adults may become less embarrassed by being involved in something like this, that there would be more of an encouragement to report it so that we can get better data and a better sense on how big the problem is.

There are prevalent studies of financial exploitation among older adults. The prevalence studies have said that it seems to be about 5% of the population that experiences it, but many of us who study this problem think it's actually much bigger just because of the reluctancy in reporting that can happen because of the embarrassment of being involved in something like this.

Donovan Maust:

And I would think you'd be particularly reluctant to report if it was a family member. So I would think that as much under-reporting as there is, it'd be even more if it was family.

Dr. Duke Han:

I think that that's absolutely a logical sentiment. And that's part of the reason why when we did our study at the National Center on Elder Abuse calls, we were surprised actually how far and away much more prevalent reporting was of family members being involved, in financial abuse in particular.

Matt Davis:

I mean, you touched on some of this already, but why older adults? What makes them more susceptible to scams, and why are they often a target in some of these?

Dr. Duke Han:

Yeah. And I think this is a very important and necessary question to address. I first need to make very clear that not all older adults are going to be susceptible to scam or fraud. We really are talking about a portion of older adults.

There may be an ageist perspective in this that, as people get older, they're automatically going to be, or that we're automatically going to be more susceptible, but that's absolutely not what we're finding or what we're saying. There's actually a number of studies that show that age is not necessarily on its own the factor that makes a particular older adult susceptible to scam or fraud. We've also talked about the examples of family members or caregivers being involved in this. And so in that sense, really the blame is on the family member or caregiver.

That being said, we do believe that some older adults may be susceptible or vulnerable to financial exploitation, and the reasons are really... As I've been doing this work for coming on 10, 15 years now, I'm starting to appreciate that the vast many reasons why particular older adults in particular situations might be vulnerable to scam or fraud.

So we've talked about cognitive impairment a little bit. So as an older adult becomes cognitively impaired, our research and research with the Rush Alzheimer's Disease Center has found that people with mild cognitive impairment, for example, that they do tend to be more susceptible to scam or fraud. They tend to make poorer financial decisions on a whole, and that's adjusting for age, education, sex, and cognitive ability in some cases. We do find that if someone's experiencing cognitive impairment, that they may be more susceptible to scam or fraud.

I will say that, in addition to cognitive impairment, there are other reasons why certain older adults might be more vulnerable. In the field, it's often talked about that social isolation is one of the strongest risk factors for abuse. If an older adult is socially isolated and they might be feeling lonely, they might be more open to interacting with someone that might be scamming or defrauding them.

We also have found in our laboratory research that older adults who report a financial exploitation experience also seem to be more frail. They rate higher on a frailty index. In particular, on one study, we found that older adults who have hearing and vision problems, who seem to have poorer hearing and vision, seem to also... That seems to be more highly reported among older adults who've been scammed or frauded.

That makes sense. If someone has poor vision, poor hearing, they may not be able to sense when scam or fraud is happening or pick up on clues that might indicate that it's a scam or fraud. Along those lines, we think that older adults who have just poorer health are going to be more vulnerable because they're more dependent on other people. If older adults have to be dependent on others, that creates an environment where an older adult may become the victim of scam or fraud.

Donovan Maust:

I'm going to jump out of order here just a minute, Matt, because Duke was touching on one of the questions we had later, sort of getting at, in addition to cognition, what are other factors that seem to, say, increase susceptibility to fraud that... You just touched on a couple. I guess I also wonder about more personality-based traits, like if you're more, I don't know, introverted. I guess are there other facets that seem to influence susceptibility?

Matt Davis:

Like trusting personality types or something?

Donovan Maust: Yeah.

Dr. Duke Han:

Yeah. That's a great question, and it's actually one of the most common questions I get when I give talks on this topic, I can share with you when we've looked at personality in the Rush Alzheimer's Disease Center data... And their data is vast. I mean, there are huge numbers of people, and they are incredibly well-characterized from a cognitive and personality standpoint.

We've looked at things, like introversion, extroversion, neuroticism, these personality characteristics that you might assume might have an impact. In general, so far, we haven't seen much impact from those things actually. It makes sense that might be the case, but honestly, we haven't been seeing it bear out in our data yet.

That might change obviously as other groups start to study this or start to study this in different ways, but so far personality doesn't seem to be as big of a factor as some of these other factors I mentioned, so things like health, cognitive impairment. We think the more dependent older adults might be on others in whatever way that might manifest, that that might create an environment where exploitation might happen.

Donovan Maust:

Okay. Now, I'm going to jump to the question that I should have asked next, which was if you think about the natural history of a financial scam, how do they usually end? For a given individual, what's the end point? What makes it stop?

Dr. Duke Han:

So I wish I could say that each experience of exploitation ends in a good way where the legal system takes the scammer to task. Honestly, based on the majority of cases that we've seen, because of the lack of reporting, often nothing happens. I'm sad to say that, but it is generally, I think, more true than not.

That being said, the legal systems and the governmental systems are great to try to pursue situations that are particularly egregious or that have affected a lot of older adults. There's lots of reporting resources that are funded by the government that allow people to report when they've been the victim of scam or fraud. In many of these cases when they are reported, when enough people report, or if there's a particularly very good case of where someone was just egregious in what they did, then local authorities will try and prosecute that and bring it to justice.

Actually, I will say that many people think, "Well, they might not be able to ever get back their money anyway. So what's the point?" And in many of these cases, they are able to get something back actually, so just a general encouragement for older adults that might be listening. Please consider reporting. There's lots of ways to report. You could report anonymously if you would like. The more that people are willing to bring this forward, the more that something can be done about it.

Matt Davis:

This isn't a legal podcast, but it's got to be tricky, right? I mean, some of these are probably from overseas, and I mean, laws have boundaries, and states, and nations, and stuff. So is that part of the issues with the legal stuff in terms of actually getting money back and that kind of stuff?

Dr. Duke Han:

I believe that's part of it. The legal side of this is not something that I know much about. I can't really speak on what causes a district attorney to prosecute, for example, or to go after some cases versus others, but I think one thing is clear. If people don't report it, nothing can be done about it. So it really just takes that first step to be proactive and try to get something done about it.

I think it's not just for the sake of the particular older adult involved. It's really for all of us actually because if you think about it, the burden is not on only on the older adult. It's on everyone because of the effect on society.

Matt Davis:

So many of our listeners are researchers out there. And one of the questions I had about your research... I know you've looked at susceptibility to scams. From a research perspective, how exactly do you measure scam susceptibility?

Dr. Duke Han:

Yeah. So I think this is a really important question that's still being worked on right now. How we have done it is there was a susceptibility to scam scale that was developed by Dr. Patricia Boyle at the Rush Alzheimer's Disease Center. That scale was developed based on interviews that the AARP and the FINRA organization did over adults who had been scammed or frauded.

It's a five-item scale. Just to give you an example, the first item is I'll answer the phone, even if I do not know who is calling. So if an older adult rates that item highly, you might imagine that they might be more susceptible to scam or fraud. That measure is out there. It's a five-item scale. The items have been published.

Then how we're doing it at USC is that we're actually actively interviewing people who have reported financial exploitation experiences. We are working with a qualitative researcher to interview every person that has reported an instance of this just so that we could get a better handle on how to assess for it. One of the goals of that is to try to develop better ways to assess for vulnerability in the future.

Other colleagues of mine... Actually, Dr. Peter Lichtenberg who's not far from you all in Michigan, he's in Detroit at Wayne State, has developed a number of scales of what he is calling financial capacity, and how you develop, and how you can measure that in older adults. Those scales are freely available online as well.

Donovan Maust:

One of the last times that I spoke to my mom, she was telling me about how the phone rang. It's not a number she knew. She answered it. She knew that this person was trying to sell her something or scam her something, and she was explaining to me how she basically was like, "I knew what they were up to, and I was challenging them on the phone." I was like, "Mom, just don't talk to them. You're wasting your time." Anyways, I have personal experience with family members dealing with calls like that.

Dr. Duke Han:

Yes. Yeah. We generally advise people just to not respond or to just hang out. We do have some people that we work with, some older adults that have engaged, like you just shared. As long as people are safe about it and they know what's going on, it's whatever people are comfortable with.

Matt Davis:

Do do-not-call lists help at all?

Dr. Duke Han:

Do-not-call lists, I believe, help. Any sort of method where you can get people to not call, I think, will help. Phone and mail are far away at this point in time... We've mentioned internet, but phone and mail, far and away, are still among older adults in particular the most popular ways that older adults are scammed or frauded from strangers, in particular. So the less that people answer their phone or respond to mail, I think, in my respects or in what we study... Yeah, for what we study, it's probably for the best.

Donovan Maust:

If we can just take a brief detour, and this might be my own ignorance about the research in this area, this seems a little bit like maybe an unconventional research area or I don't know. Maybe that's less the case now than when you got started 10 or 15 years ago. How did you actually get into this area as your area focused, Duke?

Dr. Duke Han:

Yeah. So this is a really interesting question, and I always start off when I give a talk on this topic with the reasons because I think I can understand why someone would think this is a bit of an atypical topic to study, particularly for a health researcher. This started from experiences in my clinic. As a clinical neuropsychologist, I have been trained to do cognitive assessments of patients to assist with diagnosis and treatment planning. I had focused on older adults and preclinical Alzheimer's disease all my career.

I started receiving referrals for patients for cognitive assessment for probable dementia because it was discovered by either their healthcare provider or a family member or someone else that they were giving away large sums of money. This was a new change in behavior. This was not something they did before, but all of sudden, they were giving away large sums of money, either to potential romantic interests or other sorts of organizations. This was a change of behavior.

I would do a full cognitive assessment. In many cases, I would do many hours of testing, cognitive testing for a dementia-probable diagnosis. Time and time again, case after case back to back, these older adults tested normal. There was no cognitive impairment at all, but there was a clear change in behavior.

This was something that was really curious to me. It was frustrating to family members. They brought these patients forward. The referring doctors were confused by it. Honestly, often, the patients were happy with the result because they could keep doing what they were doing, or at least that was the presumption.

This got me thinking. There's a clear change of behavior. It's not every older adult where we're seeing this, and so there must be some other explanation. Around this time, there was a New York Times article that came out that just used anecdotes from Alzheimer's patients and their families. Their families reported that changes in the way that the dementia patients that went on to develop dementia, that changes in financial handling was one of the first signs of the dementia. It was that, and it was not memory impairment or not cognitive impairment.

This got a number of us thinking. I was a part of the Rush Alzheimer's Disease Center at the time. It was just a really curious set of clinical and potential research questions that converge into a program of research of trying to understand what makes particular older adults more susceptible to scam or fraud.

If you interview me 20 years ago, there'd be no way I would've told you that I guess that I'd be studying this as my career, but it has been my career. Since that time, a number of us in the field have focused on this topic. It's an incredibly complex topic, and we do believe actually that, or at least a number of us do believe that changes in financial handling might be one of the earliest signs of dementia down the road, even ahead of any sort of noticeable cognitive or memory impairment.

Our lab has been focusing on this. We had a grant to study this right now actually in non-cognitively [inaudible 00:25:45] older adults that we're following longitudinally. We're following a set of older adults who have been the victims of financial exploitation and comparing them to a set of older adults who have not been, and seeing if we can look and find signs of potential Alzheimer's disease or dementia that might be happening as we follow these participants over the next few years.

Donovan Maust:

For those folks that you mentioned seeing clinically, do you have any longitudinal data on any of them? Do you know if any of them went on to develop dementia?

Dr. Duke Han:

I do not, unfortunately. Yeah, that would be a great question. I've taken a step back from clinical work, so I don't do as many clinical evaluations as I used to. That would be a great question to see. We do believe that it could be one of the earliest functional signs of Alzheimer's disease, and so that would be a great question to ask of these patients over time.

Matt Davis:

Now, just sort of flipping things around... And we're sort of thinking about people that have a cognitive limitation or issue being vulnerable, but flipping that whole thing around, it does make you wonder about the causation. I mean, are the people from your perspective, people that may be victim to a scam or something before a formal diagnosis... Have they just gone undiagnosed, do you think, or is it some other kind of more precursor in the development towards dementia?

Dr. Duke Han:

We think that at least some older adults who have been the victims of scam or fraud may be having early brain changes in particular areas of the brain that are more susceptible to age-related neuropathology, such as amyloid plaque and tangle pathology, and that the functional changes that are implied by this financial change in financial capacity or financial handling are because of these early brain changes.

And so a lot of our published work to date has been in non-demented older adults, but showing that there are particular brain imaging metrics in very specific brain regions that we know are susceptible to age-related neuropathology. These are, again, non-demented older adults.

Just to really drive this home and make it clear, one of our published studies, we used this susceptibly to scams measure that was developed by Patricia Boyle, and looked in over 300 non-demented older adults, and found... These are non-demented older adults, but we found less gray matter density in the right hippocampus, corresponding with greater susceptibility to scam or fraud.

Again, this is non-demented older adults, adjusting for age, education, sex, and cognitive ability. So we're adjusting for cognitive ability, and we're seeing less gray matter density in the hippocampus, which we know is susceptible to age-related neuropathology, being associated with greater susceptibility to scam or fraud. This is one study to support this idea of why we think changes in financial handling might be one of the earliest signs of Alzheimer's disease.

We've since developed this idea because of the default mode network and the nodes of the default mode network, which we know again are susceptible to age-related neuropathology, the posterior part of the default mode network is the area... Those are the areas that tend to decline in the context of Alzheimer's disease, and those are the areas that correspond with things like episodic memory decline.

So that model is very well worked out. At many of the Alzheimer's conference, it's presented on, but what's interesting is that the anterior part of that network, the medial prefrontal cortex, which we also know is very susceptible to age amyloid accumulation in particular, that doesn't decline as much in the context of Alzheimer's disease, but that's heavily involved in decision-making, and we presume financial decision-making.

What we think is that since there's this age-associated neuropathology that accumulates in the default mode network, if it accumulates more so in the front part of the default mode network, that would actually lead to these changes in financial behavior that might make an older adult more susceptible to scam or fraud. Then either concurrently or before or after, the timeframe can actually vary a bit, the posterior part of the default mode network, which corresponds to episodic memory decline, can happen. You can have both of these things potentially happening one before the other or at the same time. That's generally the model that we're working from right now, and that's the specific model that we're trying to test with our current grant.

Donovan Maust:

You mentioned a couple times the default mode network. I think you're our first podcast guest who has mentioned that. So for our listeners who might be confused, could you just give a brief one or two-second explanation of what exactly the default mode network is?

Dr. Duke Han:

Oh, I will try. There's a lot that's been published on the default mode network. It's a network of brains that has been implicated in non-intentional thinking. It was first highlighted and identified because people were interested in looking at what was happening in the brain when people were not doing something. It's generally thought to be active. It was originally thought to be active during times of daydreaming or when you're not actively thinking about something. It has since been found to be active, even when you're thinking about something, but this network has been identified as being very important for just multiple really important human functions.

We also know that this particular set of brain regions is very susceptible to amyloid accumulation, and the posterior part declines in the course of Alzheimer's disease, very clearly. The anterior part does decline, but mostly in the later part. That's more than two seconds, but...

Donovan Maust:

That's great. So it's a little bit kind of like the background resting activity of the brain, something like that?

Dr. Duke Han:

Yes. Yeah. That's actually one of the ways that it's identified is through resting, what we call a resting fMRI, a resting functional brain MRI scan.

Matt Davis:

We've been talking a little bit about susceptibility as a measurement. I'm kind of curious, in terms of the literature and where things are at, has anybody just shown straight up in an observational study that victim rates directly differ and are associated with levels of cognitive decline?

Dr. Duke Han:

So that's a general presumption. I am not personally aware of any direct data that has actually verified this point. It's a general assumption and presumption that cognitive impairment is associated with greater rates of financial vulnerability. But as I was saying before, we don't have really great rates in the first place. So it's hard to really tease that apart and drill down on whether or not people with cognitive impairment or dementia might actually be more experiencing scam or fraud.

Until we honestly have better studies and better data on that, I think that's always going to be a presumption. What we do have are lots of studies showing that if you try to give a financial decision-making measure to someone with MCI and someone with dementia, they will in a step-wise fashion do worse. So the people with MCI will do worse than people without cognitive impairment. The people with dementia will do worse than the people with MCI.

Matt Davis:

That's a really good design, right, and actual experiment?

Dr. Duke Han:

Yeah. That would be great. Well, it would be great to have that actual data. It's one of the things that everyone in the field hopes for at some point. There is a general reliance on sort of proxies, proxies of susceptibility, proxies of vulnerability. There are a number of measures out there right now that are actively looking at that. But in terms of actual data, that's something that... I think it will take a long time to get real, actual, gold-standard epidemiologic data on fraud, actual fraud, actual victimization.

Matt Davis:

What do we know from... People talk about a dose-response, higher levels of some exposure and more outcome. Have people looked at levels of cognitive impairment, all the way up to full dementia, and shown sort of more susceptibility across levels?

Dr. Duke Han:

So we have a study showing that MCI definitely is lower than people who are cognitively intact. We had a direct comparison study showing that on a scale of susceptibility to scams. In terms of the Alzheimer's patients, I don't know if that's been looked at yet. Patricia Boyle at Rush might know actually because I think they would be able to have that data to look at that. From what I understand, I just don't know if that's been done yet.

Matt Davis:

I think we were sort of wondering if there's a point when people get true dementia, that there'd be a point in which more caregiving would be available that might have a protective effect to some degree.

Dr. Duke Han:

Yeah, you would hope, but I will say... And I do think that, in general, the vast majority of caregivers are obviously beneficial to dementia patients. Unfortunately, there are instances of caregivers also exploiting patients with dementia from a financial standpoint. That's something that actually my colleague, Laura Mosqueda, in my department has a grant to try to look at, and see, and try to intervene upon.

Matt Davis:

What's being done right now to try to reduce financial exploitation?

Dr. Duke Han:

I wish I can give you a laundry list of all the things that are being done. There's not as much done as there should be done, I'll say in answer to that question. The National Institute on Aging has a number of grants to try to understand this issue better. This topic is still not well understood, and I think there'll be a lot of really great data coming out in the near future.

One example is I have a colleague at the University of Florida who is investigating the impact of email phishing on older adults, where they're emailing older adults, and actually sending them emails to try to phish older adults, and see what they respond to. So there is really great work, trying to develop ways that could help older adults, protect older adults, and help older adults protect themselves against financial exploitation.

I have colleagues at the AARP that are working on something called the BankSafe Initiative. That's where they're working with the financial institutions to try to get them to develop safeguard tools for older adults' financial well-being. So there's a lot of different initiatives out there that are trying to attack this at different angles, I'll say, but honestly, there needs to be more done.

For what it's worth, I think you guys doing a podcast on this topic is helpful. I think the more that this topic is talked about, it helps diminish the potential shame or stigma involved, the more... It makes this topic accessible so that people can either participate in research or find out more about initiatives or report when these situations happen. All of these address different levels of this problem that need to be addressed. Yeah, I think we're all doing our part in different ways to try to address this problem.

Donovan Maust:

Is there some mechanism for people to report? Are you just supposed to call the police or is there a national helpline or something? What do you actually do?

Dr. Duke Han:

Yeah, that's a great question. So there's actually a number of different hotlines and ways to report. Our actual Senate of our country has a fraud hotline. That hotline is 1-855-303-9470. There's also an online way that you can report. It's aging.senate.gov/fraud-hotline. If people experience internet fraud, the FBI maintains a website called ic3.gov. And that's it in terms of a website, ic3.gov. It's a way for older adults to report if they've been the victim of an internet scam or fraud.

Then the FTC also has a reporting website. It's reportfraud.ftc.gov. That's something that people can... Again, you can report anonymously. You can report non-anonymously. It helps to identify these fraud scenarios, and people can do something about it.

There was one question that you guys asked, was have the scams changed over the last decade? I was just going to say, unfortunately, COVID scams are a big deal right now. There's things like people will steal personal information from vaccination cards that are posted on Facebook, fake charities. What's really egregious is funeral assistance programs. These are all mostly targeted to older adults.

Then the other sort of thing that's rearing its head right now is crypto. It used to be gift cards that people would funnel money, but you can't trace crypto. Older adults are being forced to put money into crypto without even knowing anything about crypto, without even knowing that they could be losing money. Those are all things that are sort of the new scams that are happening right now.

You had a question about what are the new things, and the thing about these scams is that they're always changing. They're always changing with the times. They're always trying to take advantage of whatever is happening at the moment.

Before vaccines came out, there were huge vaccine or treatment promises scams, so pills that would prevent COVID, marketed to older adults because... This was before anything was developed. It's because scammers knew that they can exploit the fear. It's really sad.

I started as an Alzheimer's researcher. That was my interest in this is trying to identify the earliest cognitive signs of Alzheimer's disease. I've always been interested in preclinical Alzheimer's disease, and so when this sort of presented itself, it was an interesting topic. Then I've appreciated how it's not just within the health area. There's a lot of it that has legal interests and financial institution interests, I'll say. So the financial institutions don't want to see large sums of money sent to fraudsters either.

There's been sort of aligned interests across lots of different spheres of life, and it's a topic that... I hadn't really encountered that before, where financial institutions are interested in not having people scammed or frauded also. The FBI is very interested in not having people scammed or frauded. So I've been in more multidisciplinary meetings, I'll say, than I have in my prior years as someone just focusing on Alzheimer's disease.

I'm constantly thinking about the policy implications. One thing I do not want is older adults to be stripped of any sort of rights or privileges. That's absolutely the last thing that we want, and so there's just a lot of implications of this work.

Matt Davis:

Such an important topic and a novel area of research. Duke, thanks so much for joining us.

Dr. Duke Han:

Sure. Yeah, thanks for having me. I really appreciate it.

Matt Davis:

If you enjoyed our discussion today, please consider subscribing to our podcast. Other episodes can be found on Apple Podcasts, Spotify, and SoundCloud, as well as directly from us at capra.med.umich.edu, where a full transcript of this episode is also available. On our website, you'll also find links to our seminar series and data products we've created for dementia research.

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