Cognitive Aging, Health, and Money: Why We Need “Whealthcare”


Cognitive Aging, Health, and Money: Why We Need “Whealthcare”

Ana Bonilla Martinez, Rutgers, SUMR '16

Dr. Max Gomez, a CBS medical correspondent, got a disturbing phone call one day about his elderly father, a physician as well. He found out that his father was in serious financial and legal trouble for risky and unusual business transactions. His father didn’t know how or when it happened, and eventually he lost his business and all his savings. A once financially stable man, his father now lives in an assisted living facility, relies on Medicaid to pay the bills, and remembers little about his business.

In my first week, I learned that patients may not be clinically diagnosed with mild cognitive impairment, yet be at a higher risk of scams.  That’s because aging adults experience cognitive aging, which can impair decision-making. Often the way cognitive impairment manifests itself is in financial decisions like paying rent and bills. When an elderly person falls prey to scammers or financial abuse, families, friends, and taxpayer move in. Since most older adults do not have an income but are relying on savings they have accumulated, or Social Security, major financial loss can have serious implications for their housing, medical care, health, and social life.

While the thought of retirement may be far away for some of us, we are still affected by the senior population one way or another. Everyone is affected by this problem, as we have aging parents, elderly grandparents, or simply because we are taxpayers. The 65+ age group is growing, as medicine and public health help people live longer:

Figure 1: Population age 65 years and older, 1900 to 2050

Source: West et al., 2014

The financial vulnerability of older people has prompted many researchers to start thinking about cognitive aging as a public health problem. My mentor for the summer, Dr. Jason Karlawish, refers to this field as whealthcare, which is the concept of nurturing and maintaining wealth and health. Whealthcare in the field of cognitive research is key in developing public health based strategies of prevention through collaboration of public and private entities.

So how could Dr. Gomez’s father have been protected by public health interventions? Dr. Karlawish argues that established intervention in public health, such as the social ecological model, can help prevent financial abuse within elderly adults. The model requires intervention at the individual, relationship, community, and societal level. For example, new software that allows for supervision of transactions for consenting older adults could be a way to monitor for suspicious money transfers. This alone would require the creation of public policy, new banking policies, and an increased awareness of the financial consequences of cognitive aging.

Who will be the first to notice suspicious or abnormal banking activity? The doctor who sees his or her patient once a year or the teller at the local bank? Doctors should not be the only ones to monitor for signs of major cognitive change, and in reality they can’t be the only ones. Like other public health concerns, cognitive aging has to be monitored by many sections of society to prevent any harm. After all, financial loss due to cognitive change takes a toll on everyone, from families, friends, and society, as previously self-sufficient individuals must rely on the social safety net to make up for what has been taken from them. 

Ana Bonilla Martinez is a senior at the School of Arts and Science at Rutgers, New Brunswick.  Learn more about her here.