1. SCAMS: Influencing the Aging Brain Erik Lande, Ph.D. Ventura County APS Rapid Response Team UCSB, Psychology Assessment Center, Hosford Clinic drlande@insightneuropsychology.com

2. Scams

3. Why Do Scams Work?

4. Techniques of Persuasion Visceral rewards Emphasize urgency Demonstrate authority Use a personal touch

5. Techniques of Persuasion Visceral rewards Emphasize urgency Demonstrate authority Use a personal touch

6. The Aging Brain

7. Anatomical Changes Brain volume peaks around the 20’s Atrophy begins around the 40’s

8. Anatomical Changes Cerebral blood flow and metabolism decline

9. Aging Effects on Thinking Speed of information processing slows Complex attention declines Problem-solving unfamiliar tasks becomes harder

10. What Remains Strong As We Age Vocabulary, verbal reasoning, comprehension, and arithmetic skills Well practiced/familiar skills and knowledge Wisdom Basic attention

11. Frontal Lobe Hypothesis of Aging West RL (1996) An application of prefrontal cortex function theory to cognitive aging. Psychological Bulletin 120:272-292.

12. Frontal Lobe Hypothesis of Aging West RL (1996) An application of prefrontal cortex function theory to cognitive aging. Psychological Bulletin 120:272-292.

13. PFC atrophies more and quicker than other brain regions PFC has vast connections with other brain regions, so deficits here affect many other brain functions

14. PFC atrophies more and quicker than other brain regions PFC has vast connections with other brain regions, so deficits here affect many other brain functions

16. Iowa Gambling Test

17. IGT and the PFC PFC damage results in difficulty learning from one’s mistakes and decreased self- awareness Similar to those with disinhibition conditions

18. IGT and Seniors Those over 55 generally do worse than those under 55 Similar performance to those with disinhibition 35% do much worse than peers Denburg NL, Tranel D, Bechara A. The ability to decide advantageously declines prematurely in some normal older persons. Neuropsychologia 2005;43(7):1099–1106. Denburg, N. L., Cole, C. A., Hernandez, M., Yamada, T. H., Tranel, D., Bechara, A., & Wallace, R. B. (2007). The orbitofrontal cortex, real-world decision-making, and normal aging. Annals of the New York Academy of Sciences, 1121, 480–498. Fein, G., McGillivray, S., & Finn, P. (2007). Older adults make less advantageous decisions than younger adults: Cognitive and psychological correlates. Journal of the International Neuropsychological Society, 13, 480–489.

19. IGT in Alzheimer’s and MCI Looks different than that seen in healthy seniors More random responses and poor strategy stability Zamarian, L., Weiss, E.M., & Delazer, M. (2010). The impact of mild cognitive impairment on decision making in two gambling tasks. Journal of Gerontology: Psychological Sciences, 66B(1), 23–31, Zamarian, L., Weiss, E.M., & Delazer, M. (2010). The impact of mild cognitive impairment on decision making in two gambling tasks. Journal of Gerontology: Psychological Sciences, 66B(1), 23–31,

20. Conclusions Aging disproportionately affects the frontal lobe Results in decreased ability to process information in a rapid and complex manner Results in generally increased susceptibility to scams involving urgency and visceral/emotional information

21. Conclusions About 30% of otherwise healthy seniors have even greater PFC atrophy Causes impulsivity, obsessiveness, and poor judgment Regular abstract reasoning may be fine, but reasoning involving emotional/visceral ideas is poor and an easy target for scammers

22. What Can We Do? Recognize Warning Signs and Make Families Aware of these –Changes in financial behavior –Memory lapses –Decreased checkbook management skills –Disorganization –Arithmetic mistakes –Financial concepts confusion –Generally impaired judgment

23. What Can We Do? Educate about scams, but realize education is often not the problem, it is lack of insight into their deficits Educate by helping them learn about their own impaired reasoning and impulsivity Once insight present, compensatory strategies such as phone hang-up devices or financial assistance or supervision may help Management of finances may become necessary REMEMBER, we want to help while respecting their autonomy!

24. Consider a Professional Evaluation Use a neutral expert who understands capacity assessment Disciplines include geriatricians, neurologists, psychiatrists, geropsychologists and neuropsychologists Clearly identify the specific question you want addressed!

25. www.InsightNeuropsychology.com 805-988-6197