If you haven’t yet dealt with a client showing signs of diminished mental capacity, you will. Now is the time to prepare for that event, before you see the signs.
Amy Florian can deliver the alarming statistics on the likelihood that your clients — and you — will face that dreaded development associated with aging. In an interview with ThinkAdvisor.com, Florian provided steps advisors should take to protect themselves from liability, and when to take action.
First, the sobering statistics. Florian, CEO of the consulting firm Corgenius, which specializes in educating businesspeople on death and dying and “transitions” like divorce and retirement, reported that one in nine people age 65 or older and almost half of people age 85 or older have some form of dementia. There are 18 different diseases that can lead to dementia, with Alzheimer’s disease by far the leading cause, followed by vascular dementia. However, one common misconception is that Alzheimer’s and dementia are the same thing. They are not; you can have dementia and not have Alzheimer’s, but if you suffer from Alzheimer’s you do have dementia.
(Florian is speaking at the Schwab Impact 2016 conference on Oct. 28 in a session titled, ‘Guiding Women Clients Through Life Transitions.’)
“We don’t know the cause,” said Florian, and “if we knew, then we’d have a better idea on how to prevent or treat” dementia. Some people can get early onset Alzheimer’s in their 40s, and the “familial” variety of Alzheimer’s, she said, “is definitely genetic, but that’s a small percentage” of those affected by the disease.
Researchers do know what characterizes Alzheimer’s, in that “every Alzheimer’s person has beta-amyloid plaques” in their brain which, the Alzheimer’s Association says, “may block cell-to-cell signaling” in the brain’s synapses. Those clumps of protein “may also activate immune system cells that trigger inflammation and devour disabled cells,” the Association warns.
Florian noted, however, that while all Alzheimer’s sufferers have those beta-amyloid clumps, that condition is also found in people without dementia.
Current medications for Alzheimer’s, said Florian, can’t reverse the condition, but only delay the worsening of symptoms, and all too often they only work for a relatively short period of time before the condition worsens again.
One thing we do know about dementia, Florian said, is that it “strikes as we get older.” Moreover, “we can’t predict who will get it,” and Alzheimer’s in particular “literally shrinks the brain.”
The Challenges and Strategies for Advisors
The symptoms of dementia can start 10 to 12 years before a diagnosis, Florian said, but one important point for advisors is that “not every cognitive difficulty is due to dementia.” The symptoms common to dementia might be caused by medications interacting with each other, she said, like anti-depressants. Even a fairly common condition like a urinary tract infection “can wreak havoc with cognition,” she said, as can a B-12 vitamin deficiency.