Posted February 5, 2020

Carole Roan Gresenz, Ph.D., Georgetown University

  Dr. Maiken Nedergaard, University of Rochester
Dr. Carole Roan Gresenz

Dr. Carole Roan Gresenz, currently interim dean for Georgetown University’s School of Nursing & Health Studies, was lead author on a paper examining the risk for adverse financial effects due to Alzheimer’s disease (AD) prior to clinical diagnosis of the condition. Dr. Gresenz and her colleagues (Drs. Jean M. Mitchell, James Marrone, and Howard Federoff) identified a significant risk of adverse financial outcomes during the years prior to AD clinical diagnosis due to compromised decision-making and exploitation and fraud by others.

The full study, funded by the Peer Reviewed Alzheimer’s Research Program award W81XWH-16-1-0746, was published in “Health Economics” (Gresenz CR, Mitchell JM, Marrone J, Federoff HJ. Effect of early‐stage Alzheimer's disease on household financial outcomes. Health Economics 2020 Jan;29(1):18-29. doi: 10.1002/hec.3962. Epub 2019 Oct 24). Prior studies indicated that individuals in the early stages of AD lose their ability to manage their checkbook, to pay bills on time, and in other ways fail to wisely manage their financial affairs. Dr. Gresenz and her colleagues examined in detail the question: “What happens to financial household outcomes during that period of cognitive decline prior to diagnosis?” Data from the Health and Retirement Study and Medicare claims were merged. The data from the Health and Retirement Study, funded by the National Institute on Aging, provided information on households’ financial assets and liabilities while the Medicare data identified individuals diagnosed with AD, or a related dementia, and the date of the actual diagnosis. The combined data provided information on financial risks during the period prior to diagnosis of AD for a patient’s household.

Dr. Gresenz and her colleagues found that households in which someone is in the early stage of the disease are vulnerable to large reductions in liquid assets (e.g., savings, money market, and checking accounts) and were likely to have a reduction in net wealth during this pre-diagnostic period. Dr. Gresenz stated that: “The findings are concerning because these adverse financial outcomes are occurring just prior to when substantial resource demands will be placed on these families as they grapple with substantial costs related to caregiving needs.” The findings, she indicated, highlight the potentially important role of financial institutions in reducing the exposure of the vulnerable elderly to poor financial outcomes.

Dr. Gresenz and her colleagues are continuing their work by examining credit data linked with Medicare data, which will provide a more granular picture of financial outcomes during specific time periods prior to AD diagnosis. The study will allow the researchers “to understand more about the specific types of financial decisions and choices…as well as to explore whether financial information offers the potential for early identification of individuals who are in the initial stages of Alzheimer's disease and who should be prioritized for additional clinical screening.”

The majority of the information above was extracted from a publicity release prepared by Karen Teber of Georgetown University:

Additional information about the study and its results may be found at:

  1. The National Public Radio article:
  2. Deborah Hirsch’s interview of Dr. Gresenz for HealthDay:
  3. Rachel Nania’s interview with Dr. Gresenz for the American Association of Retired People (AARP):,
  4. The write-up of the study on webMD:, and
  5. A write-up of the study on Psych Central:


Public and Technical Abstracts: Effects of Alzheimer’s Disease in the Prediagnosis Period on Financial Outcomes

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