The Independent Effect of Depression on Financial Decision-Making in Older Adults

To determine the association between clinically significant depressive symptoms in late life or late-life depression (LLD) and financial and healthcare-related decision-making in older adults.

821 older adults from the Rush Memory and Aging Program underwent a cross-sectional evaluation of depressive symptoms, cognitive functioning, and a performance-based measured of financial and healthcare decision-making. Participant data on financial and health literacy were also obtained. Rush clinicians assigned a diagnosis of mild cognitive impairment (MCI) or normal cognition (NC) based upon review of the clinical data, and participants were assigned to one of three groups based on the presence of clinically significant depression and antidepressant medication use: active depressive symptoms, remitted depressive symptoms, or no-depression. Patients with dementia were excluded from the current analyses.

Depression status was not associated with the total decision-making score. However, active depression, MCI status, financial literacy, and demographics were statistically significant independent predictors of financial decision-making. MCI status, but not depression status, was a significant predictor of healthcare decision-making.

Older depressed adults may be at risk for impaired financial decision-making. Evaluation of financial decision-making should be considered in research and clinical management of depression in older adults and could lead to the early identification of seniors at risk for financial exploitation.