We tend to think of Alzheimer’s disease as a condition of memory. But in practice, one of the earliest places it shows up is something we don’t talk about enough: financial stability.
At BrainLove, we see this pattern all the time. Families may come in with a vague sense that something isn’t right. Decisions feel a little different. There’s a shift in follow-through, organization, or judgment. It’s hard to pinpoint, but enough to create unease. And then, over time, something else becomes clear: their financial position has changed too.
There’s now research backing this up. Studies using the Health and Retirement Study have shown that people who go on to develop Alzheimer’s disease often have similar wealth to their peers years earlier, but by the time of diagnosis, their net worth is significantly lower. So this isn’t just about the cost of late-stage care. Something is happening earlier.
I’ve started thinking about this as Alzheimer’s-Associated Financial Erosion—a cycle where insidious, progressive cognitive and functional changes lead to financial vulnerability, which then limits options, increases stress, and ultimately contributes to worse outcomes. And once that cycle starts, it can be difficult to interrupt.
Part of the reason this happens is that the same abilities we rely on to manage finances are affected early in Alzheimer’s disease:
- executive function,
- judgment,
- the ability to manage complexity, and
- the capacity to catch and correct errors.
So what looks small on the surface, such as a missed payment, a strange purchase, a delay in making a decision, can actually be one of the first real-world signs that something is changing. We’re getting much better at early diagnosis. We’re talking more about biomarkers, imaging, and disease-modifying therapies. All of that matters. But in the middle of this progress, I find myself asking a different question: is this person’s ability to manage their financial life changing? And we don’t routinely ask that.
If we really mean early intervention, then this has to be part of it. Not in a way that removes autonomy, but in a way that protects it. That might look like simplifying financial systems, integrating a trusted family member. putting gentle guardrails in place, and having conversations before things become urgent. Because once financial damage has occurred, it’s often not reversible.
Some of the hardest moments for families aren’t the diagnosis itself, they’re the realizations that come after. “We didn’t realize what was happening.” “We thought it was just normal aging.” “We wish we had stepped in sooner.” That’s the gap. Not just medical, but structural and financial.
Alzheimer’s and related progressive aging brain diseases doesn’t just affect memory. They affect how people function in the world, how they make decisions, manage their lives, and maintain stability over time. If we’re not paying attention to the financial piece, we’re missing something that is both common and, in many cases, preventable.
We’re asking better questions about diagnosis. The next question is what we’re actually protecting when we diagnose earlier. Because it’s not just the brain, it’s the person’s life, their agency, their stability, and the resources that support these.
References
Choi H, Langa KM, Norton EC, Cho TC, Connell CM. Changes in Care Use and Financial Status Associated With Dementia in Older Adults. JAMA Intern Med. 2023 Dec 1;183(12):1315-1323.
Li J, Skinner JS, McGarry K, Nicholas LH, Wang SP, Bollens-Lund E, Kelley AS. Declines in Wealth Among US Older Adults at Risk of Dementia. JAMA Neurol. 2023 Nov 1;80(11):1250-1252.
