Aggressive sales tactics and scams in dementia: an exploratory study

Abstract

Introduction: The financial exploitation of vulnerable persons is a growing concern in modern societies. People with cognitive impairment may be particularly susceptible to fraud and misdirection. Our goal was to evaluate whether people with cognitive impairment (mild cognitive impairment and mild/moderate stage dementia) are more susceptible to fraud and deception than healthy controls. Methods: A case-control study, including patients with mild cognitive impairment or mild/moderate dementia and age-sex matched controls, seen in an outpatient dementia clinic between 2021-2023, in a tertiary hospital. Demographics and clinical data were obtained via clinical records. Financial exploitation, fraud, and excessive purchases characterization were obtained through a telephone questionnaire applied to caregivers or family members of people with cognitive impairment and to controls. To evaluate susceptibility to scams, a 5-item questionnaire, 7-point Likert scale, was also applied. Data were analysed using SPSS version 27.0, using a p-value of 0.05. Approval by the local ethics committee was obtained. Results: Twenty-two pairs of matched individuals were compared (54.5% female, with a mean age of 69.5±8.3 years old). People with cognitive impairment showed a mean of susceptibility to scams (scale from 1-7) of 3.97±0.97 and controls showed 3.61±0.78 (p=0.178). The average prevalence of fraud was 13.6% (18.2% in cases and 9.1% in controls, p=0.380). Excessive shopping was found in 22.7% of cases and 4.5% in controls (p=0.185). People with cognitive impairment reported greater difficulty in successfully ending a telephone call (p=0.013) and decreased awareness of heightened vulnerability (p= 0.015). Conclusion: People with cognitive impairment may be susceptible to fraud. The extent of which needs to be confirmed in future studies with more robust statistics. Importantly, they display reduced call-handling skills and decreased awareness of vulnerability, which may place them at risk for scammers who operate over the telephone. Social and legal action is necessary to protect this vulnerable segment of the senior population.