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Are People at High Risk for Dementia More Vulnerable to Scams?

Are People at High Risk for Dementia More Vulnerable to Scams?

Fraudsters are constantly developing new schemes to swindle people. Older people are often targeted by scammers and are more vulnerable to falling prey. People with Alzheimer's disease are known to experience a decline in complex executive functions, such as planning and impulse control. Since financial decision-making requires executive function, people with dementia show an increased tendency to give away money to scammers. This suggests that the ability to detect scams could be used to assess executive function and dementia risk. A recent study set out to investigate whether scam awareness could be an early sign of cognitive impairment and an indicator of future cognitive decline.



Researchers assessed the scam awareness of 935 older people from the Chicago metropolitan area participating in the Rush Memory and Aging Project [1]. The average age of participants at the start of this study was 81 years old, and their cognitive status was evaluated annually for an average of 6 years. None of the participants showed clinical signs of dementia at the start, but over the course of the study 151 of them developed dementia.

Scam awareness was measured using a questionnaire testing the willingness of a person to engage in behaviors that make him or her more likely to fall prey to scammer tactics. Participants indicated their agreement toward the following statements using a 7-point rating scale.

  1. I answer the telephone whenever it rings, even if I do not know who is calling.
  2. I have difficulty ending a telephone call, even if the caller is a telemarketer, someone I don't know, or someone I did not wish to call me.
  3. If something sounds too good to be true, it usually is.
  4. Persons older than 65 are often targeted by con artists.
  5. When telemarketers call me, I usually listen to what they have to say.

Low scam awareness was demonstrated by agreement toward questions 1, 2, and 5, and disagreement toward questions 3 and 4. Higher scores indicated lower scam awareness. A one-point increase on the total score was associated with a 60% increased risk for dementia and a 50% increased risk for mild cognitive impairment. The responses to questions 2 and 3 were the primary drivers of these associations. This suggests that low scam awareness could be an early sign of cognitive decline.

The study also found that the loss of scam awareness was associated with the accumulation of Alzheimer's pathology, namely amyloid plaques and tau tangles, in certain regions of the brain. This may explain why a decline in the ability to detect scams could be an early sign of future cognitive decline.

Of course, people of all ages with normal cognitive function can and do fall victim to scammers, thus being a victim of fraud alone does not indicate whether a given person will or will not develop dementia.

Also, it is important to note that this questionnaire alone cannot be used to identify whether a given person is at risk for future cognitive decline. Testing scam awareness is likely to be most useful when combined with measures of other complex behaviors that also require executive function. Future studies are needed to develop and validate these predictive assessments. However, this questionnaire can be used to bring awareness to the behaviors that make someone vulnerable to scammers and serve as a starting point for a conversation with loved ones.



The best way to protect yourself and your loved ones from being victims of a scammer is to become familiar with the behaviors that make someone most vulnerable, and then develop an action plan to modify these behaviors. For example, one of the most common scammer approaches is to use time pressure to force someone to a make a quick decision. Therefore, it can be useful to practice delay tactics with family members and create prepared responses, such as "I need to discuss this with my family first."

It can be challenging to stay ahead of the scammers with new scams being developed all the time, but there are excellent resources available that provide information on the latest scams and best practices for avoiding them.



The United States Senate Special Committee on Aging releases an annual report on the top scams targeting seniors and national resources for fraud victims, including a toll-free helpline (855.303.9470).

The AARP Fraud Watch Network provides alerts about active scams, and their toll-free helpline (877.908.3360) can offer tips on how to avoid fraud and guidance about next steps for victims of fraud.


  1. Boyle PA, Yu L, Schneider JA et al. (2019) Scam Awareness Related to Incident Alzheimer Dementia and Mild Cognitive Impairment: A Prospective Cohort StudyScam Awareness, Alzheimer Dementia, and Mild Cognitive Impairment. Annals of Internal Medicine.

Betsy Mills, PhD, is Senior Program Manager of Aging and Alzheimer’s Prevention at the Alzheimer’s Drug Discovery Foundation. She earned her doctorate in neuroscience at Johns Hopkins University School of Medicine, where she studied the role of glial cells in the optic nerve and their contribution to neurodegeneration in glaucoma; and completed a Postdoctoral fellowship at the University of Michigan, where she worked to uncover genes that could promote retina regeneration. Dr. Mills has a strong passion for community outreach, and served as program presenter with the Michigan Great Lakes Chapter of the Alzheimer's Association to promote dementia awareness.

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