Financial Exploitation and Psychological Distress: The Interacting Effect of Health Behaviors and Income

Abstract

Financial exploitation (FE) of older adults is associated with adverse mental health outcomes. However, little is known about factors that buffer or exacerbate these effects. This study examined whether income level and health behaviors moderate the relationship between FE and psychological distress in later life. Community-dwelling adults aged 50 and older (N = 277) completed measures of psychological distress, health behaviors, income, and perceived FE. Hierarchical linear regression analyses were conducted, controlling for background characteristics and number of medical conditions. FE, lower income, and worse health behaviors were each linked to increased distress. A significant three-way interaction was found: among participants with low health behavior engagement, the relationship between FE and distress was strongest in lower-income individuals. Conversely, among participants with high health behavior engagement, the relationship was strongest in higher-income individuals. These findings suggest that both income and adaptive health behaviors may not uniformly protect against the emotional toll of FE.

Keywords

financial exploitation psychological distress health behaviors older adults resilience

Get full access to this article

View all access options for this article.

References

Acierno

Hernandez-Tejada

Muzzy

Steve

(2009). National elder mistreatment study. National Institute of Justice.

Acierno

Hernandez-Tejada

M. A.

Anetzberger

G. J.

Loew

Muzzy

(2017). The national elder mistreatment study: An 8-year longitudinal study of outcomes. Journal of Elder Abuse & Neglect, 29(4), 254–269. https://doi.org/10.1080/08946566.2017.1365031

Acierno

Watkins

Hernandez-Tejada

M. A.

Muzzy

Frook

Steedley

Anetzberger

(2019). Mental health correlates of financial mistreatment in the national elder mistreatment study wave II. Journal of Aging and Health, 31(7), 1196–1211. https://doi.org/10.1177/0898264318767037

Aslan

Erci

(2020). The incidence and influencing factors of elder abuse and neglect. Journal of Public Health, 28(5), 525–533. https://doi.org/10.1007/s10389-019-01071-7

Beach

S. R.

Czaja

S. J.

Schulz

(2023). Novel methods for assessment of vulnerability to financial exploitation (FE). Journal of Elder Abuse & Neglect, 35(4-5), 151–173. https://doi.org/10.1080/08946566.2023.2281672

Beach

S. R.

Schulz

Castle

N. G.

Rosen

(2010). Financial exploitation and psychological mistreatment among older adults: Differences between African Americans and non-African Americans in a population-based survey. The Gerontologist, 50(6), 744–757. https://doi.org/10.1093/geront/gnq053

Biswas

P. I.

Faulkner

G. E.

Bajaj

R. R.

Silver

M. A.

Mitchell

M. S.

Alter

D. A.

(2015). Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: A systematic review and meta-analysis. Annals of Internal Medicine, 162(2), 123–132. https://doi.org/10.7326/M14-1651

Bots

Tijhuis

Giampaoli

Kromhout

Nissinen

(2008). Lifestyle‐and diet‐ related factors in late‐life depression—a 5‐year follow‐up of elderly European men: The fine study. International Journal of Geriatric Psychiatry, 23(5), 478–484. https://doi.org/10.1002/gps.1919

Boyce

C. J.

Brown

G. D.

Moore

S. C.

(2010). Money and happiness: Rank of income, not income, affects life satisfaction. Psychological Science, 21(4), 471–475. https://doi.org/10.1177/0956797610362671

10.

DeLiema

Conrad

K. J.

(2017). Financial exploitation of older adults. Elder Abuse: Research, Practice and Policy, 141–157.

11.

DeLiema

Deevy

Lusardi

Mitchell

O. S.

(2020). Financial fraud among older Americans: Evidence and implications. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 75(4), 861–868. https://doi.org/10.1093/geronb/gby151

12.

DeLiema

Gao

Brannock

Langton

(2025). The effects of risky behaviors and social factors on the frequency of fraud victimization among known victims. Innovation in Aging, 9(2), igae111. https://doi.org/10.1093/geroni/igae111

13.

DeLiema

Gassoumis

Z. D.

Homeier

D. C.

Wilber

K. H.

(2012). Determining prevalence and correlates of elder abuse using promotores: Low-income immigrant latinos report high rates of abuse and neglect. Journal of the American Geriatrics Society, 60(7), 1333–1339. https://doi.org/10.1111/j.1532-5415.2012.04f025.x

14.

Drapeau

Marchand

Beaulieu-Prévost

(2012). Epidemiology of psychological distress. Mental Illnesses-Understanding, Prediction and Control, 69(2), 105–106. https://doi.org/10.5772/30872

15.

Giannouli

Hall

Lichtenberg

P. A.

(2025). Do older black women who were financially exploited share specific psychological, cognitive, social and physical health characteristics? The role of financial exploitation vulnerability. Journal of Applied Gerontology: The Official Journal of the Southern Gerontological Society, 07334648251347998. https://doi.org/10.1177/07334648251347998

16.

Gunther

(2023). The scope of elder financial exploitation: What it costs victims . AARP BankSafe Initiative. https://doi.org/10.26419/ppi.00194.001

17.

Hamilton

N. A.

Catley

Karlson

(2007). Sleep and the affective response to stress and pain. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 26(3), 288–295. https://doi.org/10.1037/0278-6133.26.3.288

18.

Hayes

A. F.

(2018). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford publications.

19.

Hodge

Almeida

O. P.

English

D. R.

Giles

G. G.

Flicker

(2013). Patterns of dietary intake and psychological distress in older Australians: Benefits not just from a mediterranean diet. International Psychogeriatrics, 25(3), 456–466. https://doi.org/10.1017/S1041610212001986

20.

Itani

Jike

Watanabe

Kaneita

(2017). Short sleep duration and health outcomes: A systematic review, meta-analysis, and meta-regression. Sleep Medicine, 32, 246–256. https://doi.org/10.1016/j.sleep.2016.08.006

21.

Kahneman

Tversky

(1979). Prospect theory: An analysis of decision under risk. Econometrica, 47(2), 263–291. https://doi.org/10.2307/1914185

22.

Knox

Muros

J. J.

(2017). Association of lifestyle behaviours with self-esteem through health-related quality of life in Spanish adolescents. European Journal of Pediatrics, 176(5), 621–628. https://doi.org/10.1007/s00431-017-2886-z

23.

Kroenke

Spitzer

R. L.

Williams

J. B.

Löwe

(2009). An ultra-brief screening scale for anxiety and depression: the PHQ–4. Psychosomatics, 50(6), 613–621. https://doi.org/10.1016/S0033-3182(09)70864-3

24.

Lachman

M. E.

Weaver

S. L.

(1998). The sense of control as a moderator of social class differences in health and well-being. Journal of Personality and Social Psychology, 74(3), 763–773. https://doi.org/10.1037//0022-3514.74.3.763

25.

Lachs

Berman

(2011). Under the radar: New York state elder abuse prevalence study. Prepared by lifespan of greater Rochester. Inc., Weill Cornell Medical Center of Cornell University and New York City Department for the Aging.

26.

Lavery

A. L.

Hasche

DePrince

Gagnon

Srinivas

Boyce

(2020). Mental health consequences and service use of older adults at risk of financial exploitation. Social Work Research, 44(4), 257–265. https://doi.org/10.1093/swr/svaa018

27.

Lee

I. M.

Shiroma

E. J.

Lobelo

Puska

Blair

S. N.

Katzmarzyk

P. T.

Lancet Physical Activity Series Working Group . (2012). Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy. Lancet (London, England), 380(9838), 219–229. https://doi.org/10.1016/S0140-6736(12)61031-9

28.

Leipold

Klier

Dapperger

Schmidt

(2024). Physical activity and nutrition in relation to resilience: A cross-sectional study. Scientific Reports, 14(1), 2272. https://doi.org/10.1038/s41598-024-52753-6

29.

Lichtenberg

P. A.

Stickney

Paulson

(2013). Is psychological vulnerability related to the experience of fraud in older adults? Clinical Gerontologist, 36(2), 132–146. https://doi.org/10.1080/07317115.2012.749323

30.

Lichtenberg

P. A.

Sugarman

M. A.

Paulson

Ficker

L. J.

Rahman-Filipiak

(2016). Psychological and functional vulnerability predicts fraud cases in older adults: Results of a longitudinal study. Clinical Gerontologist, 39(1), 48–63. https://doi.org/10.1080/07317115.2015.1101632

31.

Lusardi

Hasler

Yakoboski

P. J.

(2021). Building up financial literacy and financial resilience. Mind & Society, 20(2), 181–187. https://doi.org/10.1007/s11299-020-00246-0

32.

Manstead

A. S.

(2018). The psychology of social class: How socioeconomic status impacts thought, feelings, and behaviour. The British Journal of Social Psychology, 57(2), 267–291. https://doi.org/10.1111/bjso.12251

33.

McEwen

B. S.

(2007). Physiology and neurobiology of stress and adaptation: Central role of the brain. Physiological Reviews, 87(3), 873–904. https://doi.org/10.1152/physrev.00041.2006

34.

McMullin

J. A.

Cairney

(2004). Self-esteem and the intersection of age, class, and gender. Journal of aging studies, 18(1), 75–90. https://doi.org/10.1016/j.jaging.2003.09.006

35.

Mosafer

Soltani

Rostami

Sharifi

Mohammadi

(2024). Factors associated with financial exploitation in older adults: A systematic review. Geriatric Nursing, 61, 662–671. https://doi.org/10.1016/j.gerinurse.2024.10.028

36.

Mueller

E. A.

Wood

S. A.

Hanoch

Huang

Reed

C. L.

(2020). Older and wiser: Age differences in susceptibility to investment fraud: The protective role of emotional intelligence. Journal of Elder Abuse & Neglect, 32(2), 152–172. https://doi.org/10.1080/08946566.2020.1736704

37.

Nguyen

A. L.

Mosqueda

Windisch

Weissberger

Axelrod

Han

S. D.

(2021). Perceived types, causes, and consequences of financial exploitation: Narratives from older adults. The Journals of Gerontology: Series B, 76(5), 996–1004. https://doi.org/10.1093/geronb/gbab010

38.

Nolte

Hanoch

Wood

Hengerer

(2021). Susceptibility to COVID-19 scams: The roles of age, individual difference measures, and scam-related perceptions. Frontiers in Psychology, 12, 789883. https://doi.org/10.3389/fpsyg.2021.789883

39.

Peterson

J. C.

Burnes

D. P.

Caccamise

P. L.

Mason

Henderson

C. R.

Wells

M. T.

Berman

Cook

A. M.

Shukoff

Brownell

Powell

Salamone

Pillemer

K. A.

Lachs

M. S.

(2014). Financial exploitation of older adults: A population-based prevalence study. Journal of General Internal Medicine, 29(12), 1615–1623. https://doi.org/10.1007/s11606-014-2946-2

40.

Puterman

Lin

Krauss

Blackburn

E. H.

Epel

E. S.

(2015). Determinants of telomere attrition over 1 year in healthy older women: Stress and health behaviors matter. Molecular Psychiatry, 20(4), 529–535. https://doi.org/10.1038/mp.2014.70

41.

Rebar

A. L.

Stanton

Geard

Short

Duncan

M. J.

Vandelanotte

(2015). A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health Psychology Review, 9(3), 366–378. https://doi.org/10.1080/17437199.2015.1022901

42.

Rimmele

Zellweger

B. C.

Marti

Seiler

Mohiyeddini

Ehlert

Heinrichs

(2007). Trained men show lower cortisol, heart rate and psychological responses to psychosocial stress compared with untrained men. Psychoneuroendocrinology, 32(6), 627–635. https://doi.org/10.1016/j.psyneuen.2007.04.005

43.

Schonfeld

Larsen

R. G.

Stiles

P. G.

(2006). Behavioral health services utilization among older adults identified within a state abuse hotline database. The Gerontologist, 46(2), 193–199. https://doi.org/10.1093/geront/46.2.193

44.

Stamatakis

Gale

Bauman

Ekelund

Hamer

Ding

(2019). Sitting time, physical activity, and risk of mortality in adults. Journal of the American College of Cardiology, 73(16), 2062–2072. https://doi.org/10.1016/j.jacc.2019.02.031

45.

Stewart

A. L.

Hays

R. D.

Wells

K. B.

Rogers

W. H.

Spritzer

K. L.

Greenfield

(1994). Long-term functioning and well-being outcomes associated with physical activity and exercise in patients with chronic conditions in the medical outcomes study. Journal of Clinical Epidemiology, 47(7), 719–730. https://doi.org/10.1016/0895-4356(94)90169-4

46.

Sun

Buys

Wang

(2012). Association between low income, depression, self efficacy and mass-incident-related strains: An understanding of mass incidents in China. Journal of Public Health, 34(3), 340–347. https://doi.org/10.1093/pubmed/fdr107

47.

Van Gils

Dom

Dierckx

Van Alphen

S. P. J.

Franck

(2022). Resilience, depression and anxiety and hazardous alcohol use behaviour among community dwelling older adults. Aging & Mental Health, 26(1), 56–64. https://doi.org/10.1080/13607863.2020.1870211

48.

Watkins

D. C.

Johnson

N. C.

(2018). Age and gender differences in psychological distress among African Americans and Whites: Findings from the 2016 national health interview survey. Healthcare, 6(1), 6–17. https://doi.org/10.3390/healthcare6010006

49.

Weissberger

G. H.

(2022). Anxiety and depressive symptoms are associated with perceived financial exploitation in Israeli older adults. Clinical Gerontologist, 45(3), 715–721. https://doi.org/10.1080/07317115.2022.2053022

50.

Weissberger

G. H.

Mosqueda

Nguyen

A. L.

Samek

Boyle

P. A.

Nguyen

C. P.

Han

S. D.

(2020). Physical and mental health correlates of perceived financial exploitation in older adults: Preliminary findings from the finance, cognition, and health in elders study (FINCHES). Aging & Mental Health, 24(5), 740–746. https://doi.org/10.1080/13607863.2019.1571020

51.

Whitehead

B. R.

(2017). Health behaviors in older adults: Considering age, affect, and attitudes. Journal of Health Psychology, 22(13), 1652–1657. https://doi.org/10.1177/1359105316631814

52.

Wister

Cosco

Mitchell

Fyffe

(2020). Health behaviors and multimorbidity resilience among older adults using the Canadian longitudinal study on aging. International Psychogeriatrics, 32(1), 119–133. https://doi.org/10.1017/S1041610219000486

53.

Wood

Lichtenberg

P. A.

(2017). Financial capacity and financial exploitation of older adults: Research findings, policy recommendations and clinical implications. Clinical Gerontologist, 40(1), 3–13. https://doi.org/10.1080/07317115.2016.1203382

54.

Yan

X. Y.

Huang

S. M.

Huang

C. Q.

W. H.

Qin

(2011). Marital status and risk for late life depression: A meta-analysis of the published literature. The Journal of International Medical Research, 39(4), 1142–1154. https://doi.org/10.1177/147323001103900402

55.

Zhang

(2024). Enhancing understanding of healthy aging based on time-varying dependencies among multidimensional health, life satisfaction, and health behaviors of older adults aged 60 years and over. BMC Public Health, 24(1), 192. https://doi.org/10.1186/s12889-024-17752-2

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.10 MB