Factoring dementia into your retirement approach

by Joshua Grill, UC Irvine, via ProjectM Online

Joshua Grill is associate professor in the Department of Psychiatry and Human Behavior at the University of California, Irvine. His specialties include neuroscience, Alzheimer’s disease and clinical trials. In this conversation, he talks about the growing impact of dementia in aging societies. For a more extensive version of this interview, visit PIMCO’s DC Dialogue.

PROJECT M

Professor Grill, how is longevity changing?

Joshua Grill

Thanks to advances in medical science, the human lifespan is increasing. If this pace continues, over half of the children born this century will celebrate their 100^th birthday.

PROJECT M

What challenges does this bring?

Joshua Grill

The biggest problem related to older age is dementia. Today, more than a third of people over 85 suffer from dementia. Alzheimer’s Disease International (ADI) reports that as of 2015 over 47 million people worldwide have dementia. By 2050, this will rise to 131.5 million.

PROJECT M

Why should dementia concern pension plan sponsors and other retirement professionals?

Joshua Grill

People over 65 control a growing percentage of defined contribution assets and wealth. Cognitive decline, as a result of dementia, can inhibit sound financial decision-making and make people more susceptible to fraud. There’s also the problem of healthcare costs. The worldwide cost of dementia is over $818 billion in 2016, according to ADI’s World Alzheimer’s Report. Covering this growing expense may increase health and long-term care insurance premiums.

PROJECT M

Can someone suffering from memory loss still manage their own finances?

Joshua Grill

Brain diseases affect everyone differently. Some people may be financially impaired at the onset of dementia, while others will maintain sharp financial skills in late stages of the disease. People with dementia can also suffer from behavioral symptoms, becoming paranoid or delusional with regard to their money. Financial and legal professionals can help by writing a power of attorney and an advance health directive even prior to retirement, while cognitive abilities are intact, to foster peace of mind.

PROJECT M

Is there a way to prevent dementia and cognitive decline?

Joshua Grill

Right now, there is no known way to prevent dementia. That said, a healthy diet, sufficient sleep and exercise can all reduce the risk. Keeping the brain active and staying socially active can also help.

PROJECT M

Are there drugs to address dementia?

Joshua Grill

The US Food and Drug Administration has approved only five drugs and we haven’t had a new drug in over a decade now. Part of the problem is that we test drugs on people who already have dementia. The focus is moving towards testing drugs that target the underlying biology of the disease. Our goal is to find drugs that can delay the onset of cognitive problems and hopefully let people live out their lives without ever developing dementia.

PROJECT M

Is there a way to identify those at risk of dementia?

Joshua Grill

Yes, in one study we’re running a brain scan to identify people who have elevated levels of an abnormal protein called beta-amyloid, which accumulates in the brains of people with Alzheimer’s disease. We’re also looking for people who are at increased genetic risk due to problematic genes. The most effective therapy starts before someone develops memory problems.

PROJECT M

What can retirement professionals do to reduce the risk of elder fraud among those with cognitive decline?

Joshua Grill

Financial professionals can set up a number of protections, including automatic deposit for US social security, overdraft protection and joint checking with dual signatures for transactions above a certain amount, as well as third-party notifications for financial irregularities, such as large checks. Ultimately, an ounce of prevention is worth a pound of cure. Professionals can urge or incentivize employees and clients to put plans in place for old age while they are still cognitively healthy.

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