Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA.
The Interdisciplinary Department of Social Sciences, Bar-Ilan University, Raman Gat, Israel.
Neurosci Biobehav Rev. 2022 Sep;140:104773. doi: 10.1016/j.neubiorev.2022.104773. Epub 2022 Jul 8.
Neuropathology characteristic of Alzheimer's disease (AD) begins to accumulate years to decades before cognitive changes are clinically detectable on standard neuropsychological tests. This presents a challenge for early intervention efforts and has spurred research on the identification of behavioral correlates of early neuropathological changes. Recent evidence suggests that financial exploitation vulnerability (FEV) due to impaired decision making may serve as an early behavioral manifestation of AD neuropathology, thereby indicating an increased likelihood for subsequent cognitive decline. An understanding of the underlying mechanisms of FEV is therefore warranted for the identification of individuals at risk for cognitive decline due to AD, and for empowering and protecting older adults vulnerable to financial exploitation. In the current review, we first highlight the devastating consequences of financial exploitation of older adults. We then summarize research on the cognitive, neuroimaging, and neuropathological correlates of FEV in older adults without dementia and propose a theoretical model in which early accumulation of AD pathology manifests as FEV. We conclude with clinical implications and directions for future research.
阿尔茨海默病（AD）的神经病理学特征在认知能力发生变化之前，会在临床上通过标准神经心理学测试检测到的几年甚至几十年前开始积累。这给早期干预工作带来了挑战，并促使人们研究识别早期神经病理学变化的行为相关性。最近的证据表明，由于决策能力受损导致的财务剥削易感性（FEV）可能是 AD 神经病理学的早期行为表现，从而表明随后认知能力下降的可能性增加。因此，为了识别因 AD 而导致认知能力下降的个体，并为易受财务剥削的老年人提供支持和保护，了解 FEV 的潜在机制是有必要的。在当前的综述中，我们首先强调了对老年人进行财务剥削的破坏性后果。然后，我们总结了在没有痴呆的老年人中，与 FEV 相关的认知、神经影像学和神经病理学研究，并提出了一个理论模型，即 AD 病理学的早期积累表现为 FEV。最后，我们讨论了临床意义和未来研究方向。
