Problems managing money seem to be among the earliest and most reliable warning signs of Alzheimer's disease. Although people tend to fixate on worries about memory loss, a growing body of research suggests that financial mistakes and challenges might be the better clues to look for.
Declining money skills are evident in people with mild cognitive impairment (MCI) in the year prior to the onset of Alzheimer's disease, says Daniel Marson, a professor of neurology at the University of Alabama at Birmingham, who has done several studies on financial capacity and memory loss.
The following five money problems can signal mild dementia. This is especially true if these money problems are changes for the person or are happening with increasing frequency. It's always a good idea to have concerns about cognitive health checked out by a physician, psychologist, or memory clinic.
Money warning sign #1: Trouble counting change
What to look for: Is your loved one hesitating when paying in cash? Paying too much or too little? Opening his or her wallet and inviting the cashier to "take what you need"? These are common events when it becomes challenging to distinguish among the different bill or coin denominations or the person can't reliably do the necessary math in his or her head. It's easy to confuse nickels and quarters, but your loved one may even mix up dimes and quarters, or fives and twenties.
What you can do: In stores, you can help him or her save face (and cash) by casually offering to pay yourself: "Here, I've got it." Ideally, he or she should avoid carrying a lot of large bills or should use a debit card for purchases, drawn on an account that doesn't have a large available balance.
Money warning sign #2: Mistakes writing checks or balancing a checkbook
What to look for: Your loved one may write the date or amount on the wrong lines or leave off information completely, such as forgetting to sign the check. The amount written in numerals may not match the amount written longhand.
Balancing the checkbook is either ignored completely (after a history of faithfully doing so) or a process riddled with math errors. Some people having trouble look visibly flustered or accuse the bank of making mistakes. Others cover up blunders -- or are oblivious to them.
What you can do: Safeguards are important because managing a checkbook improperly can lead to overdraft fines and make a person vulnerable to scams (writing checks to fraudulent charities, for example). A great safety valve: having a second person become a cosigner on the checking account, so that two signatures are needed to complete a transaction. And every month when the bank statement arrives or is made available online, someone should review it to look out for math errors, overdraft fees, or suspicious check recipients.
More financial warning signs
Money warning sign #3: Neglecting to pay bills, or paying in duplicate
What to look for: Confusion over financial statements can cause one of two things to happen: The bill payer lets them pile up unopened (or, worse, throws them away without paying), or pays the same bill repeatedly.
Anybody can do these things accidentally -- occasionally. But when there's a pattern of under- or overpaid bills, it's a red flag.
What you can do: Surreptitiously monitor your loved one's mail and bank account, if possible. Check the trash for unopened bills. Convert as many routine bills as possible to an automatic payment system, and have statements sent to a post-office box or other address (so they're not mistaken for bills that are due, and paid twice).
Money warning sign #4: Falling for scams or mail fraud
In a 2008 study by University of Alabama's Daniel Marson, most healthy adults had no trouble identifying a letter that was a financial scheme. But among the subjects who had mild cognitive impairment, more were either duped by the letter or persuaded that it was a viable request for money.
What you can do: Keep watch on your loved one's bank statements -- with an eye toward large purchases or "donations" -- especially if there's already been one incident. Learn more ways to prevent scams.
Money warning sign #5: ATM confusion
What to look for: Your loved one may begin making more frequent withdrawals, such as every day, because he or she can't remember having just done so. (The extra cash quickly fills the wallet or is stuffed in a drawer or given away.)
Another common scenario: Your loved one begins having trouble working the ATM machine. He or she may try to insert an insurance card rather than a bank card, for example, or be unable to follow the prompts properly to get the desired result. Or he or she forgets a password -- and writes it down on a piece of paper.
What you can do: Watch for frequent withdrawals and track what's happening to the cash. If possible, transfer money out of the account so there's a lower balance available. If your loved one can't work the ATM, it's not safe for him or her to continue carrying a card. (Some people have been known to ask strangers to help them work the machine, sharing the password.)