Functional Connectivity Correlates of Perceived Financial Exploitation in Older Adults

Nathan Spreng,Annie L Nguyen,Laura Mosqueda,Gali H Weissberger,S Duke Han,Jenna Axelrod,Caroline P Nguyen,Patricia A Boyle

doi:10.3389/fnagi.2020.583433

Abstract

Financial exploitation (FE) in old age is devastating and common; however, the neural correlates of FE are poorly understood. Previous studies of FE in older adults have implicated declines in decision making and social cognition as two risk factors for FE in later life. Here we examined whether functional connectivity among brain regions implicated in decision making and social cognition differed for those with an experience of FE vs. those without. Participants included 16 older adults without cognitive impairment who reported FE (Mean age = 70.5, 62.5% female, Mean education = 16.0 years) and 16 demographically and cognitively matched adults who denied a history of FE (Mean age = 65.1, 37.5% female, Mean education = 15.1 years). Measures of whole-brain resting-state functional connectivity in the hippocampus, insula, and medial frontal cortex were derived for each group. Compared to the non-FE group, FE was associated with greater functional connectivity between the right hippocampus and bilateral temporal regions, and less functional connectivity between the right hippocampus and the right cerebellum and bilateral lingual gyri. The FE group showed less connectivity between the right and left insula and cingulate cortex, and between the right insula and regions of the left lateral temporal gyrus and dorsolateral prefrontal cortex. Finally, the FE group showed greater functional connectivity between the medial frontal cortex and the right lateral temporal gyrus and orbitofrontal cortex, and less functional connectivity with the right pre- and postcentral gyri. Results suggest that perceived FE in old age is associated with whole-brain functional connectivity differences involving the hippocampus, insula, and medial frontal cortex, consistent with models implicating age-associated changes in decision making and social cognition in FE.

Highlights

Financial exploitation (FE) is one of the most commonly reported types of elder abuse (Amstadter et al, 2011; Lachs and Berman, 2011)
We examined whole-brain, voxelwise functional connectivity differences for three regions of interest between a diverse group of cognitively healthy older adults who self-reported a history of FE (FE group) and demographicallymatched older adults who denied a history of FE participating in the Finance, Cognition, and Health in Elders Study (FINCHES)
After adjusting for covariates including age, sex, education, and Montreal Cognitive Assessment (MoCA) scores, FE was associated with lower functional connectivity between the right hippocampus and one cluster that included portions of the right cerebellum crus, bilateral lingual gyri, and right occipital fusiform gyrus

Summary

Introduction

Financial exploitation (FE) is one of the most commonly reported types of elder abuse (Amstadter et al, 2011; Lachs and Berman, 2011). Decision making involves prospection, or the representation of future outcomes, to simulate how events will unfold following a decision (Weierich et al, 2011) This ability is thought to be more challenging for older adults due to age-related neuropathological changes to brain regions important for prospection, and its decline may negatively impact decision making, increasing susceptibility to scams (Han et al, 2013, 2016b; Lamar et al, 2019). Evidence suggests that older adults are more trusting of others (Castle et al, 2012) and exhibit a positivity bias when forming impressions of others (Cassidy et al, 2013) These age-related changes in social cognition could contribute to greater risk of FE

Objectives

Methods

Results

Conclusion