We aimed to evaluate the prevalence of caregiver-reported financial activity and mismanagement in people with dementia.

Older adults with dementia are known to be at increased risk for financial mismanagement and abuse; however, data are lacking on how many people with dementia continue to manage finances and on the prevalence of financial mismanagement.

We conducted a nationally representative survey of 611 unpaid US dementia caregivers, with an oversampling of non-Hispanic Black and Hispanic caregivers to facilitate demographic comparisons. The caregivers reported whether care recipients had engaged in financial activities (such as making purchases, paying bills, or completing taxes) within the last year. Among those engaged in financial activities, primary caregivers reported the occurrence of financial mismanagement. We evaluated the prevalence of financial activity and mismanagement stratified by care recipient characteristics including age, gender, diagnosis, and stage of cognitive impairment.

Primary caregivers reported financial activity in 52% of care recipients over that past year. Among these, 52% had mild cognitive impairment, 30% mild, 12% moderate, and 6.9% advanced dementia. 38% of financially active care recipients had reported financial mistakes. 61% of financially active care recipients were women. Women with dementia made more financial mistakes compared to men (42% vs 31%). The prevalence of financial mistakes in care recipients with mild cognitive impairment, mild, moderate, and advanced dementia was 37%, 46%, 35%, and 20% respectively.    

A considerable proportion of people living with cognitive impairment are financially active and at risk of financial mismanagement and abuse related to their cognitive impairment. This work can inform clinical efforts to counsel caregivers, and policy efforts to diminish the risk of financial harm.