This systematic review, published in Geriatric Nursing, comprehensively investigates the factors associated with financial exploitation (FE) in older adults. Financial exploitation is defined as the “illegal taking, misuse, or concealment of funds, property, or assets of a vulnerable elder”. It is noted as the most common type of elder abuse and poses distinct challenges for older adults, often involving trusted individuals like relatives, friends, or caregivers, which can make victims hesitant to report. The prevalence of elder financial exploitation (EFA) is reported to be 26%, with older people losing an estimated 36 billion dollars annually due to EFA. Beyond financial losses, FE negatively impacts physical and mental health, reducing independence, security, well-being, quality of life, and access to healthcare, and is associated with lower self-confidence, higher rates of depression, suicide, and a 300% increase in mortality among survivors.
The primary objective of this review was to identify and analyze the complex factors linked to financial exploitation in older adults to better understand the issue and guide relevant organizations, policies, legal departments, financial institutions, and future research and interventions. To achieve this, the authors conducted a comprehensive search strategy in December 2023 across major databases including PubMed, Web of Science, Scopus, and Google Scholar, without restrictions on publication year. Of the initial 985 articles identified, 26 met the inclusion criteria for the review. Quality assessment was performed using the Newcastle-Ottawa Scale (NOS) and CONSORT tool. Due to significant variations in definitions, measures, and analytical approaches among the included studies, a narrative synthesis of the findings was undertaken.
The review highlights several key factors consistently associated with financial exploitation in older people, including:
- Cognitive function, with lower levels and deficits (e.g., slower processing speed, poorer executive functioning, memory issues) posing a significant risk.
- Depression and emotional health, as depression and emotional distress can predict and increase vulnerability to manipulation and coercion.
- Physical health, with poorer physical health, lower physical performance, and impaired instrumental activities of daily living (IADL) linked to a higher risk of FE.
- Social support and interpersonal relationships, which can be both protective and risk factors; higher social support is generally associated with lower risk, but strained relationships, negative interactions, or larger social networks (in some studies) can increase vulnerability.
- Living arrangements, with living alone consistently identified as a risk factor.
- Race, particularly African Americans, who have shown significantly higher prevalence rates of FE.
- Personality traits, such as neuroticism (associated with higher risk) and conscientiousness (also associated with higher risk in one study).
However, the review also notes inconsistencies and contradictory results regarding the association of age, marital status, and substance use with financial exploitation, indicating a need for further research in these areas. The authors conclude by emphasizing the multifaceted nature of financial exploitation and the importance of targeted interventions, awareness programs, and training for healthcare providers to mitigate risk and safeguard the financial well-being of older individuals.
Reference: Mosafer, H., Soltani, S., Rostami, Z., Sharifi, S., & Mohammadi, M. (2025). 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
