Accessing the Early Vulnerability of Individuals with Alzheimer's Disease to Adverse Financial Outcomes

Georgetown University, Washington DC

Investigators

Abstract

Project Summary Alzheimer's Disease (AD) affects an estimated 5.3 million people in the U.S. and tens of millions of people worldwide, exacting substantial human and monetary costs. Existing tools for diagnosing AD lead to diagnoses that typically occur after the onset of severe symptoms. However, significant limitations and rapid declines in financial capacity occur among patients with mild and early stage AD?long before it is typically diagnosed. Burgeoning limitations in financial capacity are unlikely to be fully appreciated or recognized by individuals and their families prior to diagnosis, and may therefore result in consequential effects on household financial outcomes such as spending, debt, and susceptibility to financial exploitation. Thus, the time period before AD is diagnosable represents a uniquely vulnerable period for individuals and households. The goal of this research is to understand how AD?before it is diagnosable using currently availability tools?affects the financial well-being of the individuals and families of those it afflicts. Our specific aims are to estimate the effects of AD before it is diagnosable on intermediate and major household financial outcomes (including aggregate household debt, loan payment delinquency, and credit scores) and seminal, culminating household financial events (such as bankruptcy or foreclosure); and to determine how the effects differ depending on the characteristics of the individual within the household who is afflicted. Our analyses rely on Consumer Credit Panel (CCP) data linked to data from the Medicare Master Beneficiary Sample-Chronic Conditions Warehouse (CCW). An understanding of the effects of AD on financial outcomes during the particularly vulnerable time before the disease is diagnosable is essential for developing a more accurate estimate of the economic costs of the disease. In addition, this research is critical to the design and development of interventions to protect vulnerable individuals and their families during this critical time period. Finally, the research is important for informing the valuation of early diagnostic tests for AD that are on the horizon. Earlier diagnosis may produce utility if it can help avert adverse financial outcomes associated with the disease before symptoms are severe enough for diagnosis with currently available tools. This potential source of value is important for both consumers and payers to consider in assessing whether to participate in or offer coverage for early testing, respectively.