Financial Exploitation Vulnerability and Social Connectedness in Middle-Aged and Older Adults Without Dementia

Abstract

Objectives:

Financial exploitation of older adults is an understudied but widespread phenomenon in the United States. Previous research examining the association between social functioning and financial exploitation vulnerability suggests that social embeddedness may be protective against financial exploitation. It is not clear, however, whether relationship depth and/or social network diversity (i.e., having many different social roles) drives this protective effect. This study aimed to examine the relationship between aspects of social connectedness (i.e., social network diversity and relationship depth) and financial exploitation vulnerability amongst community-dwelling adults aged 50 or older.

Methods:

One hundred eighteen individuals completed a laboratory visit consisting of questionnaires assessing relationship depth (i.e., Interpersonal Support Evaluation List), social network diversity (i.e., Social Network Index Total Social Roles), and financial exploitation vulnerability (i.e., Perceived Financial Vulnerability Scale; PFVS). Hierarchical linear regressions separately tested associations between financial exploitation vulnerability, relationship depth, and social network diversity.

Results:

After covarying for demographics, cognitive, and psychological variables, results showed a significant negative association between financial exploitation vulnerability and relationship depth (B(SE) = −.09(.03), p = .004). Subscale analysis indicated that a strong sense of belonging was negatively associated with financial exploitation vulnerability (B(SE) = −.28(.06), p < .001). In contrast, financial exploitation vulnerability was not significantly associated with the number of distinct social roles in one’s network (B(SE) = −.02(.11), p = .85), or with other relationship depth subscales.

Discussion:

These findings suggest potential benefits of fostering close interpersonal relationships in middle and older adulthood, such as reduced vulnerability to financial exploitation.

INTRODUCTION

Financial exploitation is an increasingly prevalent form of elder abuse, affecting thousands of older adults and generating an estimated annual loss of $3.4 billion, an increase of approximately 11% from 2022 (Federal Bureau of Investigation, 2023). Reports of financial exploitation of older adults have drastically increased over the years. It is estimated that monthly reports of fraud and scams among older adults have increased from 2,000 to 7,500 between the years 2013 and 2019 (FinCEN, 2019). Beyond the financial losses, older victims of financial exploitation may suffer from emotional and psychological consequences, including experiencing greater rates of anxiety and depression (Acierno et al., 2019). Various factors contribute to the vulnerability of financial exploitation for older adults, including accumulated financial assets, declining cognitive or physical abilities, and social isolation or dependence on others (FinCEN, 2022; Lachs & Han, 2015). Understanding and addressing these vulnerabilities is a critical public health issue, given the growing population of older adults and the rising incidence of financial exploitation.

Previous literature has identified individual-level correlates of financial exploitation vulnerability such as male gender (Wood et al., 2016), increased physical frailty (Axelrod et al., 2020), and poorer cognitive function (Fenton et al., 2022; James et al., 2014; Han et al., 2016). However, few studies have examined correlates of financial exploitation vulnerability within a broader social context. One important area within this domain is the study of social networks, as they are likely to play a crucial role in the lives of older adults by providing a sense of community and support. The few studies that have been done in this area have demonstrated associations between social functioning and rates of financial exploitation vulnerability. For example, older adults who are socially isolated have been shown to exhibit higher financial exploitation risk compared to non-isolated older adults (Gimm & Beach, 2020). Additionally, lower perceived social support has been linked to greater risk of financial mistreatment (Acierno et al., 2010) and has been identified as a predictor of financial exploitation, particularly among individuals with larger social networks (Beach, Schulz, & Sneed, 2018). Conversely, embeddedness in a group has been found to be protective against exploitation (Schafer & Koltai, 2015). Furthermore, negative interactions with social network members and lower perceived social support have been found to predict greater financial exploitation risk, while the size of the social network and positive interactions were not associated with financial exploitation risk (Liu et al., 2017). Given the mixed results from the limited empirical studies on the social correlates of financial exploitation vulnerability, it is unclear which aspects of social connectedness drive this protective factor against financial exploitation. Moreover, while other components of social network structure have been previously studied in relation to financial exploitation risk, the number of different types of social roles a person holds– social network diversity – has not yet been studied.

In this study, we aimed to develop a more comprehensive understanding of the specific factors of social functioning that are associated with the risk of financial exploitation vulnerability. We investigated whether aspects of social functioning, specifically social network diversity (i.e., the number of distinct social roles a person has within a social network such as being a family member, co-worker, neighbor, etc.), and perceived fulfillment in various social supports (i.e., relationship strength), are associated with financial exploitation vulnerability amongst a sample of cognitively healthy middle-aged and older adults. We hypothesized that both the relationship strength and social network diversity would be negatively associated with financial exploitation vulnerability.

METHODS

Participants

Participants were a sample of one hundred eighteen adults aged 50 or older from the greater Los Angeles area. Interested individuals were recruited from senior centers, community events, senior fairs, and the Alzheimer’s Prevention Registry. Recruitment materials targeted middle-aged and older adults who both have and have not experienced financial exploitation. Interested individuals initially completed a telephone screen, after which they were excluded if they self-reported an established diagnosis of dementia, neurological or psychiatric illness, or recent history of/current problems with drugs or alcohol. Participants who scored below an a priori cutoff of 21 on a modified 5-minute Montreal Cognitive Assessment (Wong et al., 2015) were also excluded.

Participants then completed an in-person laboratory visit, which included questionnaires assessing demographics, social ties and relationships, financial exploitation vulnerability, overall cognitive functioning, depression symptoms, and anxiety symptoms.

Measures

Covariates

Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) (Kroenke et al., 2001) and Generalized Anxiety Disorder-7 (GAD-7) (Spitzer et al., 2006). Scores on the Mini-Mental State Examination (MMSE) were used as a measure of cognition (Folstein, 1975). For self-reported demographic data, participants reported years of education, sex (binarily coded for male and female), and race (categorized using Census classification, (US Census, 1997)).

Primary variables

Financial exploitation vulnerability was assessed using the Perceived Financial Vulnerability Scale (PFVS) (Lichtenberg et al., 2020). This scale is based on the Lichtenberg Financial Decision Rating Scale (Lichtenberg et al., 2015) and evaluates financial awareness and psychological vulnerability related to personal finances (e.g. “How often do you wish that you had someone to talk to about your financial decisions, transactions, or plans?”, “How often has someone talked you into a decision to spend or donate money that you did not initially want to do?”). Participants respond to the six items on a 3-point scale, with a total score ranging from 6–18. PFVS scores have been found to be correlated with age-associated financial vulnerability in a population-based sample of older adults (Lichtenberg et al., 2020).

Social functioning was captured using two measures. Social network diversity was assessed using the Social Network Index (SNI) (Cohen et al., 1997), a 25-item measure that produces several outcomes. Our outcome of interest was Total Social Roles, which reflects the total number of different social roles (e.g., family, friends, co-workers) with whom the participant has contact with at least once every two weeks, with a range from 0–12.

Relationship strength was assessed using the Interpersonal Support Evaluation List-12 (ISEL-12) (Cohen et al., 1985), a 12-item measure assessing perceived availability of social support. This measure produces a Total Score, as well as three subscales with score ranges of 0–12: 1) Appraisal, or availability of interpersonal advice or guidance (e.g., “I feel that there is no one I can share my most private worries and fears with.”); 2) Belonging, or availability of interpersonal empathy, acceptance, and concern (e.g., “If I wanted to go on a trip for a day (for example to the beach, the country or mountains), I would have a hard time finding someone to go with me.”); and 3) Tangible, or availability of help or assistance, including material or financial aid (e.g., “If I were sick, I could easily find someone to help me with my daily chores”). The main variable of interest was the ISEL Total Score. We also subsequently conducted regressions for the 3 subscale scores (Appraisal, Belonging, Tangible).

Analytic Plan

Correlations were first used to examine relationships among social relationships measures (i.e., SNI, ISEL) to determine if social network diversity was associated with relationship strength. For primary analyses, two hierarchical linear regressions were used to test associations between PFVS and SNI Total Social Roles, and ISEL Total Score. We conducted separate posthoc hierarchical linear regressions between PFVS and ISEL Appraisal, Belonging, and Tangible subscales. For each hierarchical linear regression, the first block included covariates of sociodemographic variables (age, sex, race, years of education), cognition (MMSE Total Score), and depression and anxiety scores. The second block included the social measure assessed (i.e., SNI Total Social Roles, ISEL Total Score, etc). Linear regression assumptions were tested with residual and Q-Q plots in R using the ggfortify package. An alpha of .05 was used for all analyses.

RESULTS

Sample characteristics can be found in Table 1. Briefly, the majority of the sample self-identified as female (n = 86; 72.9%), White (n=85 72.0%), and with a relatively high level of education (M = 16.63, SD = 2.18). Approximately 20% (n = 23) of the sample reported a prior perceived experience of financial exploitation. On average, participants reported low severity of anxiety and depression symptoms, were cognitively intact, and described regularly participating with 5.5 different types of social roles (e.g., family, friends, co-workers). Scores on the Perceived Financial Vulnerability Scale (PFVS) were positively associated with prior financial exploitation experiences (r(116) = .34, p < .001).

Table 1.

Sample characteristics (N = 118)

Measure	M(SD) or N(%)
Age	69.33 (7.34)
Sex (% Female)	86 (72.9%)
Hispanic Ethnicity	9 (7.6%)
Race
White	85 (72.0%)
Black/African American	7 (5.9%)
Asian	14 (11.9%)
Mixed Race	9 (7.6%)
Other Race	3 (2.5%)
Years of Education	16.63 (2.18)
Perceived Financial Vulnerability Scale	8.31 (2.00)
Generalized Anxiety Disorder-7	1.92 (3.04)
Patient Health Questionnaire-9	2.36 (2.81)
Mini Mental Status Exam	28.42 (1.52)
Social Network Index Total Social Roles	5.51(1.79)
ISEL Total Score	25.87 (5.75)
ISEL Appraisal	10.06 (2.47)
ISEL Belonging	8.14 (2.80)
ISEL Tangible	7.69 (1.93)

Note. ISEL = Interpersonal Support Evaluation List

Correlations among the measures assessing social functioning (i.e., SNI, ISEL) can be seen in Table 2. Overall, SNI Total Social Roles was not associated with most ISEL scores, with the exception of a positive relationship between SNI and ISEL Belonging (r(116) = .24, p < .01). ISEL subscales demonstrated moderate to high correlations with each other and with the ISEL Total Score (rs = .42-.81, ps < .01), consistent with previous validation studies of this measure (Merz et al., 2014). Additionally, correlations among all variables used in regressions can be seen in Supplementary Table 1.

Table 2.

Correlations Among Social Measures

Measure	1	2	3	4
1. SNI
2. ISEL - Total Score	.17
3. ISEL - Appraisal	.10	.81**
4. ISEL - Belonging	.24**	.81**	.42**
5. ISEL - Tangible	.03	.77**	.51**	.44**

Note. SNI = Social Network Index. ISEL = Interpersonal Support Evaluation List.

^*p < .05.

^**p < .01

As indicated in Table 3, in separate hierarchical regressions after covarying for demographic factors, depression and anxiety symptoms, and overall cognition, PFVS was significantly negatively associated with ISEL Total Score (B(SE) = −.09(.03), p = .004) and ISEL Belonging score (B(SE) = −.28(.06), p < .001). In contrast, PFVS was not significantly associated with SNI (B(SE) = −.02(.11), p = .85), ISEL Appraisal (B(SE) = −.04(.08), p = .63), or ISEL Tangible scores (B(SE) = −.16(.09), p = .09). The nonsignificant relationship between PFVS and SNI in comparison to the significant negative relationship between PFVS and the ISEL Belonging subscale can be seen in Figure 1. Details of each hierarchical linear regression can be seen in Supplementary Table 2. Notably, anxiety symptomatology was independently associated with PFVS across all models.

Table 3.

Separate hierarchical linear regressions predicting financial exploitation vulnerability

Measure	B	SE	t	p
1. SNI	−.02	.11	−.19	.85
2. ISEL - Total Score	−.09	.03	−2.93	.004
3. ISEL - Appraisal	−.04	.08	−.48	.63
4. ISEL - Belonging	−.28	.06	−4.56	<.001
5. ISEL - Tangible	−.16	.09	−1.69	.09

Note. SNI = Social Network Index. ISEL = Interpersonal Support Evaluation List. Covariates include performance on the MMSE, anxiety, depression, sex, race, and years of education.

Figure 1.

Association between Perceived Financial Vulnerability Scale (PFVS) and 1a) Social Network Index Total Social Roles and 1b) Interpersonal Support Evaluation List (ISEL) – Belonging Score after covarying for performance on the MMSE, anxiety, depression, sex, race, and years of education. Note: association is nonsignificant in 1a) and significant in 1b). Shaded area depicts 95% confidence interval.

DISCUSSION

Among our sample of 118 cognitively unimpaired middle-aged and older adults, individuals with a weaker strength of social relationships — particularly characterized by a lack of interpersonal belonging within their social network— exhibited greater financial exploitation vulnerability. We did not observe significant associations between financial exploitation vulnerability and the number of distinct social roles (i.e., social network diversity) an individual regularly engages with, or the other markers of relationship strength (the availability of interpersonal advice or guidance or the availability of help or assistance from their support system). These findings suggest that the strength of relationships, primarily driven by a sense of belonging, may be a good indicator of protection against financial exploitation vulnerability.

To date, the existing literature on the social correlates of financial exploitation vulnerability remains limited. Our findings are consistent with the few studies that have reported that lower perceived social support, rather than social network size, is a predictor of greater risk of financial exploitation (Liu et al., 2017; Acierno et al., 2010; Beach Schulz, & Sneed 2018; Marzbani et al., 2023). This study expands upon these previous findings by examining the role of relationship diversity within social networks and stratifying perceived social support by ISEL domains: Belonging, Appraisal, and Tangible support. Notably, we demonstrated that a stronger sense of belonging within one’s social network is associated with lower financial exploitation vulnerability. Additionally, our study uniquely contributes to this literature by assessing financial exploitation vulnerability using the PFVS, a validated measure of age-associated financial awareness and vulnerability in older adults (Lichtenberg et al., 2020).

We also observed significant and independent associations between anxiety symptoms and financial exploitation vulnerability in all models incorporating social connectedness measures. Although the full significance of this is unclear, these findings support the notion that anxiety may be an important factor in financial exploitation vulnerability in older age. Future research is needed to determine the significance of these findings.

This study has several limitations and potential for future directions that must be acknowledged. First, our sample consisted of community-dwelling middle-aged and older adults living in the greater Los Angeles area who were, on average, highly educated and predominantly identified as White and female. A larger and more demographically diverse sample is required to adequately assess the generalizability of these results. Additionally, future work may benefit from exploring how culture influences perceived social support and social network diversity. Second, our study sample did not include individuals with cognitive impairment. In future research, we hope to examine the social correlates of financial exploitation vulnerability among middle-aged and older adults who have experienced financial exploitation themselves, exhibit cognitive impairments, or experience greater risk of financial exploitation vulnerability. Finally, due to the cross-sectional nature of the data, we cannot infer a causal relationship between social functioning and financial exploitation vulnerability. For example, although we identified an inverse association between a sense of belonging and financial exploitation vulnerability, we are unable to make a causal statement on whether weaker perceived social support increases vulnerability to financial exploitation or whether greater financial exploitation vulnerability leads to withdrawal from one’s social support systems.

In conclusion, the current study suggests that greater relationship strength, particularly driven by a sense of belonging, is associated with lower financial exploitation vulnerability among middle-aged and older adults. Conversely, the diversity of one’s social network appears less important in relation to financial exploitation vulnerability. This work expands on the growing literature examining the social correlates of financial exploitation vulnerability. Additionally, our findings support the notion that while social isolation and loneliness are risk factors for elder abuse, there may be benefits to maintaining close interpersonal relationships, including reducing vulnerability to financial exploitation in older age. These findings may inform interventions aimed at preventing financial exploitation amongst older adults by enhancing the quality of social relationships.

Data Availability Statement

De-identified data will be made available to qualified persons upon formal request to the corresponding author.