Friday, August 5, 2022

Fraud victimization tied to elevated BP in older men

By Regina Schaffer
Melissa Lamar

Older men without dementia who self-reported fraud victimization were more likely to experience significant increases in BP over time compared with men who did not report being victims of fraud, researchers reported.

Approximately 5 million older Americans per year experience financial exploitation, fraudulent schemes or scams, and financial losses are difficult for older adults to recover due to limited earning opportunities and shorter time horizons, Melissa Lamar, PhD, professor and clinical neuropsychologist at the Rush Alzheimer’s Disease Center in Chicago, and colleagues wrote in the Journal of the American Geriatrics Society. In addition to economic consequences, data show elder fraud may be associated with increased hospitalizations, admittance to skilled nursing facilities and lower 5-year survival rates.

‘Important public health consequences’

“These findings show that fraud victimization has important public health consequences and underscore the need for efforts to prevent exploitation,” Lamar told Healio. “Our work points toward the need to consider more stringent BP monitoring in older men after incident fraud victimization. We also need to expand this work to include greater racial, ethnic and socioeconomic diversity.”

Lamar and colleagues analyzed data from 1,211 older adults participating in the Rush Memory and Aging Project, an ongoing cohort study on aging initiated in 1997 (mean age, 80 years; 75% women). A substudy introduced in 2010 included an annual assessment of fraud victimization. The decision-making assessment included a question asking participants if, in the past year, they were a victim of financial fraud or were told they were a victim of financial fraud. During up to 11 years of annual observation, participants also underwent serial BP measurements to calculate per visit averages of systolic and diastolic BP, mean arterial pressure (MAP) and pulse pressure. Researchers examined cross-sectional associations between baseline fraud victimization and BP, and then used longitudinal data to test the hypothesis that fraud victimization is associated with increases in BP after incident fraud.

Within the cohort, 83 participants reported experiencing fraud victimization.

In adjusted models, researchers found that fraud victimization was associated with increased systolic BP (P = .04), diastolic BP (P = .007), and MAP (P = .01) compared with non-victimization. Fraud victimization was not associated with pulse pressure.

In longitudinal change point analyses, researchers found that fraud victimization was associated with elevations in BP among men but not women.

“For example, compared to pre-fraud BP levels for women, men showed an additional annual pre-fraud decline in systolic BP of 0.6 mm Hg, resulting in a total estimated annual rate of decline of 0.87 mm Hg,” the researchers wrote. “In addition, the annual rate of change in BP increased by an estimated 1.46 mm Hg post-fraud. Similar post-fraud increases were seen for the other BP metrics.”

Role of emotional dysregulation

Older adults who are victims of fraud may develop elevations in BP either directly or indirectly due in part to concomitant emotional dysregulation shown to be associated with fraud victimization, including increased stress, anger and anxiety, the researchers wrote.

“In fact, more than half of financial fraud victims (53%) report experiencing socioemotional problems involving moderate to severe levels of distress,” the researchers wrote.

The researchers noted that the study was conducted in an almost exclusively non-Hispanic white population of fraud victims and non-victims, with most reporting high levels of education, adding that more research is needed on fraud victimization among underrepresented groups while factoring in neighborhood deprivation status and social determinants of health.

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