How your bank account might predict dementia

Summary

Podcast Summary: The Indicator from Planet Money

Episode: How your bank account might predict dementia

Date: May 5, 2026
Hosts: Waylon Wong, Adrian Ma
Guest/Featured voices: Sanda Balaban (family member/caregiver), Dr. Lauren Nicholas (health economist, U of Colorado)

Episode Overview

This episode explores how early warning signs of dementia can show up in people's financial habits—sometimes years before a clinical diagnosis. It delves into new research showing a decline in financial well-being often precedes diagnosed dementia, shares the story of one family's struggle, and considers the challenges—and opportunities—for financial institutions and policymakers to better protect vulnerable individuals.

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Key Discussion Points & Insights

1. Personal Story: Financial Chaos as Dementia's Red Flag

• [01:02 - 02:04] Sanda Balaban describes her father's cognitive and financial decline, which she discovered during a crisis:

  • Her stepmother announced a divorce and asked Sanda to help move her father out.
  • Sanda found his office "the manifestation of a very deteriorated mind" (Sanda Balaban, 01:20).
  • There were piles of papers, mountains of scammy health product receipts, and regular, inexplicable large credit card bills.
  • Her father's response: "I have no idea. I don't know what that is. Like, that's gotta be wrong" (Sanda Balaban's father, 01:56).

• [03:57 - 04:26] Sanda realized her father had lost all his retirement savings—between $1–2 million—through haphazard investment decisions:

  • "There is no sense to be made of them. It was an extremely erratic, sort of pattern of investments" (Sanda Balaban, 04:26).

2. Expert Perspective: Cognitive Decline and Money Management

• [04:40 - 05:21] Dr. Lauren Nicholas, health economist, explains:

  • Dementia erodes the cognitive abilities most crucial for managing money.
  • Early signs show up in checkbook errors and missed payments—often before showing up on standard neurological exams.
  • "We actually see that some of the earliest signs show up in your financial portfolio, in your checkbook, and kind of not in the standard tests your doctors are doing" (Lauren Nicholas, 04:56).

• [05:35 - 05:59] Nicholas' research used nearly two decades of health and retirement data tracking seniors and their spouses.

• [05:59 - 06:10] Their key finding:

  • Wealth starts declining on average six years before a dementia diagnosis or any recognizable symptoms.

  • "That both surprises and worries me a lot. Right. It's like, how do you protect yourself from future you who might make these mistakes and be totally unaware of it?" (Lauren Nicholas, 06:10).

3. Why Does Wealth Decline Early?

• [06:23 - 06:57] The decline is unique to dementia:

  • Not explained by stopping work or medical costs.
  • "The decline in wealth comes from impaired financial decision making" (Waylon Wong, 06:39).
  • No similar pattern in diseases like cancer or arthritis.

• [06:57 - 07:24] Early personality changes can prompt risky, impulsive, or trusting financial behaviors.

  • "Even though you're losing these capabilities... you're actually getting more confident in your abilities and, like, you think you're crushing it" (Lauren Nicholas, 06:57).

4. The Double-Edged Sword of Intelligence

• [07:51 - 08:07] Sanda's father masked his decline:
  • Didn't pay income tax for four years before discovery.
  • "The higher your cognition, you know, the more you can cover... sort of like the residue of his former intelligence for a while" (Sanda Balaban, 07:51).

5. Calls for Financial Preventative Care

• [08:17] Sanda reflects:

  • "My father was all about preventive care... I wish that there had been financial preventative care for him and his well being" (Sanda Balaban, 08:17).

• She wishes his brokerage would've flagged erratic transactions.

6. Systemic Gaps – Financial Institutions' Role

• [08:45 - 09:17] Financial advisors and banks face dilemmas:
  • Advisors are obligated to follow client wishes and lack authority/training to intervene.
  • Privacy regulations block reporting suspicions.
  • Financial firms know the risk but fear error or overstepping boundaries.
  • 2009 Fidelity survey: most advisors faced clients with Alzheimer's; few felt confident addressing it.

7. Future Possibilities: Bridging Health and Finance

• [09:37 - 10:15] Dr. Nicholas hints at a possible future link: doctors accessing credit or financial "dementia scores" alongside cognitive tests.
  • "We're sort of hoping that we can get models that pick up enough signal in something like your credit report data where... you could determine whether you need more screening" (Lauren Nicholas, 09:46).
  • Research is ongoing; not yet ready for clinical or financial application.

8. What Caregivers Can Do

• [10:15 - 10:51] Sanda and her family now use safeguards like power of attorney and financial account monitoring for at-risk relatives.
  • These steps help prevent loss, scams, and chaos if cognitive decline sets in again.

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Notable Quotes & Memorable Moments

• Anecdote of the deteriorated office and secret debts:

  • "It was the manifestation of a very deteriorated mind" (Sanda Balaban, 01:20)
  • "What are these expenses? ... that's gotta be wrong" (Sanda Balaban's father, 01:56)

• Researcher's realization:

  • "Wealth starts declining on average six years before a diagnosis" (Waylon Wong paraphrasing, 05:59)
  • "How do you protect yourself from future you who might make these mistakes and be totally unaware of it?" (Lauren Nicholas, 06:10)

• On the challenge for intelligent people:

  • "The higher your cognition, the more you can cover... sort of like the residue of his former intelligence for a while" (Sanda Balaban, 07:51)

• Call for prevention:

  • "I wish that there had been financial preventative care for him and his well being" (Sanda Balaban, 08:17)

• On new technological promise:

  • "You could give physicians offices the ability to say, oh, do you also want us to pull your financial dementia score?" (Lauren Nicholas, 09:46)

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Key Timestamps

• [01:02] Introduction of Sanda’s story
• [04:10] Sanda realizes millions lost to erratic investments
• [04:40] Dr. Nicholas on financial signs of dementia
• [05:59] Research: Wealth drop begins six years pre-diagnosis
• [06:57] Personality changes amplify risky decisions
• [07:51] Intelligence masks decline; tax neglect discovered
• [08:17] Call for preventive financial care
• [09:17] Industry concern and hesitation
• [09:46] Future idea: “financial dementia scores” for doctors
• [10:15] Sanda’s new safeguards for caregiving

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Conclusion

This episode spotlights the silent, financial warning signs that can precede dementia by years—and the tough structural and emotional issues families and institutions face in catching them early. It provides both a cautionary and hopeful message: while our systems aren't yet equipped to bridge financial and healthcare red flags, emerging research and proactive planning by families can offer critical protection.

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For further exploration, the hosts encourage listeners to discuss such safeguarding measures with their own families and advisors.

Transcript

[A]

Hey Adrian, what do you think about when you're not working?

[B]

Food?

[A]

Of course I think about that when I am working.

[B]

Yes, I consume a lot of food, videos and podcasts and of course also a lot of actual food.

[A]

Well, there is now a place for you to discuss this even more. The Indicator has a brand new newsletter. It's a roundup of news we're following each week. Plus we answer your listener questions and importantly, we tell you what we're doing outside of work.

[B]

Yes, I would be very happy to tell you all the things I'm cooking up and or shoving in my face

[A]

nourishing the mind and body. Adrian.

[B]

Well, let me tell you about it.

[A]

No, no, save it for the newsletter. It comes out every Friday morning. Sign up [e-mail] Indicator Newsletter

[C]

NPR.

[B]

Sanda Balaban remembers when she got an email from her stepmother. It was about her father. Sanda's stepmother said she was divorcing him and Sanda needed to come help move her father out of their apartment.

[A]

Sanda and her father hadn't been in close touch for a few years. Still, she made the trip to Baltimore.

[D]

I had not been to his home for a while and I will never forget there was a room that was sort of his office. And all I can say is it was the manifestation of a very deteriorated mind.

[B]

There were piles of papers everywhere. And when Sanda tried to start packing up the office, she realized with horror what these documents were. They were credit card statements showing that Sanda's father was spending thousands of dollars every month on scammy looking health products and online subscriptions. She found that clutter in the office, too.

[D]

And when I said, you know, dad, like what? What are these expenses? He said, I have no idea. I don't know what that is. Like, that's gotta be wrong.

[A]

Sanda's father didn't have an official diagnosis, but she could see he was in cognitive decline and the illness had also ravaged his financial life. This is a common experience among families where someone is suffering from dementia. Today, new research shows that financial well being can actually start declining years before a clinical diagnosis. This is the indicator from Planet Money. I'm Waylon Wong.

[B]

And I'm Adrian Ma. After the break, we learn about those warning signs when they show up and why safeguarding the financial health of seniors is falling through the policy cracks.

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[A]

when Sanda Balaban discovered her father's mental state. She moved him into her one bedroom apartment in New York. Then she began the arduous process of trying to reconstruct what had happened to her father's finances.

[B]

For example, she realized that her father had lost essentially all of the retirement money and savings he had in his brokerage account. She estimates it was between 1 and 2 million dollars. Sanda got the brokerage to send her 10 years worth of financial statements.

[D]

I could not make sense of them. I and it turns out part of the reason I could not make sense of them is that there is no sense to be made of them. It was an extremely erratic, you know, sort of pattern of investments.

[A]

This is the kind of anecdote that Lauren Nicholas has seen before. Lauren is a health economist and professor of geriatrics at the University of Colorado. She's heard of older adults with dementia doing things like compulsively shopping or moving their entire investment portfolio into a single stock.

[C]

Dementia is one of the diseases where you lose a lot of cognitive capabilities over time that are unfortunately closely tied to our ability to manage our own money. We actually see that some of the earliest signs show up in your financial portfolio, in your checkbook, and kind of not in the standard tests your doctors are doing.

[B]

These are the kinds of tests where patients might draw an analog clock showing a specific time or memorize a list of three unrelated words. Someone could pass those tests while also missing credit card payments or responding to scam text messages.

[A]

Lauren had done previous research indicating that a person's wealth can decline before the actual onset of dementia, but she wanted to know how early this starts and why it Happens.

[B]

So Lauren and several colleagues got nearly two decades of data from a national survey, and it tracks the health and retirement of older adults and their spouses over time. The researchers used this data set for a working paper that was published in January.

[A]

And for that first question, how early does wealth start declining? The researchers found that it's about six years before a dementia diagnosis or symptoms that are recognizable as dementia.

[C]

That both surprises and worries me a lot. Right. It's like, how do you protect yourself from future you who might make these mistakes and be totally unaware of it?

[B]

The second question Lauren and her colleagues tackled was why people with dementia see their wealth deteriorate. For example, is it because they have to stop working and give up their income? Is it because they're purposely spending down their money in their twilight years? Or is it because dementia is an expensive disease to treat?

[A]

It turns out none of these were the case. The researchers found that the decline in wealth comes from impaired financial decision making, and they believe this is unique to dementia. That's because people with other diseases like cancer or arthritis do not see the same kind of drop in household wealth.

[C]

Some personality changes happen early in the course of cognitive decline, which can include propensity to trust people, your risk tolerance. What happens commonly is like, even though you're losing these capabilities, starting to forget about making your bill payments or something, you. You're actually getting more confident in your abilities and, like, you think you're crushing it.

[A]

Oh, that's such a cruel aspect of the disease.

[C]

Yeah, it's really like it does all of the worst things to you.

[B]

Sanda Balaban, who discovered her father's drained accounts, says she thinks he was able to mask his cognitive and financial issues for a long time. For example, when she started going through his papers, she discovered he hadn't paid income tax since 2014. That's four years before she found all the credit card bills and scam products in his office.

[D]

He was a very intelligent man, and at various neurologist assessments afterwards, I was told that sort of like the higher your cognition, you know, the more you can cover. And so there was sort of like the residue of his former intelligence for a while.

[A]

Sanda's father had a medical degree and a master's in public health. He had trained as an epidemiologist and a family practice physician. He retired in the early 2000s.

[D]

You know, my father was all about preventive care, medical care, and I wish that there had been financial preventative care for him and his well being.

[B]

For example, Sanda says she wished her father's brokerage had a way to flag his erratic investment transactions. This is something economist Lauren Nicholas has thought about as well. That's because brokerages or financial advisors are often the ones who are privy to these decisions around money.

[A]

However, Lauren says it's tricky to put financial advisors in the position of first responder. They're obligated to do what the client asks. They're not qualified to diagnose dementia. And privacy regulations prevent a financial advisor from calling someone's doctor to say, hey, this person might be in trouble.

[B]

And this same dilemma applies to companies like banks. They have anti money laundering and fraud systems that can detect suspicious activity. But should they use similar technology to try to predict whether a client has dementia? That's not their business.

[A]

Financial services companies are aware of this problem. Back in 2009, Fidelity surveyed financial advisors and found that most of them had dealt with a client with Alzheimer's disease. But many also reported they didn't feel comfortable raising the issue because they were afraid of being wrong or didn't have the proper expertise.

[B]

Lauren says one idea for linking the financial and healthcare industries is to give doctors access to some personal data, like information from a credit report.

[C]

We're sort of hoping that we can get models that pick up enough signal in something like your credit report data where we could give physicians offices the ability to say, oh, do you also want us to pull your financial dementia score? And you use that to determine whether you need more screening. I think we're still a few years out from that on the research horizon, but sort of seems like a promising way.

[A]

As for Sanda, she was able to get her father enrolled in Medicaid. He spent his last few years at a memory care center in New York. Sanda said he was well cared for there. He passed away in August. She's still dealing with the financial aftermath of her father's illness.

[B]

Meanwhile, another one of Sanda's family members has received an Alzheimer's diagnosis. This time, though, Sanda and her brother were able to make a plan. They set up a power of attorney and got themselves added to the family members financial accounts. These are safeguards that Sanda hopes will prevent her father's experience from happening again.

[A]

This episode was produced by Cooper Katz McKimmon, engineered by Jimmy Keeley. It was fact checked by Sierra Juarez. Julia Ritchie edited this episode. Katy Cannon is our editor and the indicator is a production of npr. This message comes from Capella University.

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