Shirley Mueller, MD
Shirley Mueller, MD
Shirley Mueller, MD is a physician turned financial consultant and investment educator who specializes in guiding clients, both one-on-one and in groups, about how to effectively self-invest using a simple and effective three-step approach

Swindled Seniors: A specific brain abnormality may be the cause

Older folks caught in a scam may not be in the early stages of dementia, simply lonely or experiencing “normal aging.” Instead, a unique brain defect may explain the vulnerability.


“We’re building a place for her right next to us,” said our neighbor. He was referring to his wife’s mother who had been living successfully alone in another part of the city until she was swindled by some “tree experts.” The daughter and son-in-law were left holding the bag. They didn’t want it to happen again so they were making plans to move her next door to them.


Seniors are defrauded at a higher rate than the general population. This is why they are targeted by shysters who have anything to sell. One of the most devastating is when rouge financial professionals influence older vulnerable citizens in such a way that they make poor financial decisions. This can lead to loss of part or all their entire life savings.


Interestingly enough, these unfortunate occurrences need not be due simply to social isolation, naiveté or memory problems related to dementia or Alzheimer’s disease. It has recently been suggested that there is another cause that is unique and specific.


Natalie Denburg, PhD, and colleagues from the University of Iowa found that changes in the prefrontal region of the brain are associated with impaired decision making in the elderly. This area includes the ventromedial prefrontal cortex, which is important in triggering physical changes in reaction to stimuli for a positive or negative outcome.


Their evidence comes from several sources. One is the use of the Iowa Gambling Task to test real life decision making, in this case fraudulent advertising. Skin conductance is measured at the same time to gauge the subject’s emotional response to the duplicitous promotions. The researchers found that one-quarter to one-third of older adults who seemed to be otherwise healthy tested as impaired. This means that in response to test marketing, they chose a high immediate reward that had a greater long-term negative effect. In contrast, the normal or unimpaired decision makers selected a low immediate reward that had a higher long-term payback.


Then magnetic resonance imaging (MRI) studies of 20 of the unimpaired older adults compared to 20 of the impaired were performed. They revealed that the latter showed a relative thinning of an area within the ventromedial prefrontal cortex compared to the unimpaired. Since this region is important for intricate emotion connected with decision making, its comparative absence in the impaired group could be clue to their inability to make advantageous complex decisions for themselves.


Taking this one step further, positron emission tomography (PET) was used to examine glucose uptake, an indication of cell metabolism in 24 unimpaired compared to 24 impaired decision makers. This test indicated that the impaired group had a lower metabolism in specific areas of the brain that are central for emotional states. There was no difference in the medial temporal lobes important for memory.


As a composite, these research results support the concept that some older adults vulnerable to fraud are predisposed to it due to defects in their prefrontal cortex. Psychometric, MRI and PET studies supported this concept. Since the prefrontal circuitry involved had to do with emotion, this faulty Input in complex decision-making was found to be associated with a predisposition to scams under the study conditions. The temporal lobe, implicated in dementia, was not found to play a part in this subset.


The bad news

So, it seems that our notions of why the graying population is notorious for involvement in fraudulent schemes will have to be extended. Their propensity to be swindled is not necessarily a result of early memory problems or a psychological reason such as loneliness. Rather, there can be a structural problem (thinning of the ventromedial prefrontal cortex) that is associated with a physiological manifestation (lower glucose metabolism).


The good news

Recognition of the cause of vulnerability to fraud can be used to more effectively protect oldsters from becoming victims. One way, among others, the authors suggest would be legislative. Perhaps neuroscientists can inform Congress just as economists have and effective policy solutions could follow.


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