Medicare beneficiaries who develop dementia are more likely to begin missing bill payments as early as six years before a clinical diagnosis, according to a new study.

These misses and other adverse financial mistakes may lead to an increased risk of lowered credit scores. This impact on credit can be seen 2.5 years before a dementia diagnosis, the researchers reported.

They also found that Medicare recipients with a lower educational status began missing payments as early as seven years before diagnosis, as compared to 2.5 years prior to a diagnosis for beneficiaries with higher educational status. What’s more, rates of higher payment delinquency and credit risk persisted for up to 3.5 years after beneficiaries received their dementia diagnoses.

These mistakes may serve as early predictors of dementia and highlight the benefits of earlier detection, said lead author Lauren Hersch Nicholas, Ph.D., of Johns Hopkins University, Baltimore. They also suggest an ongoing need for assistance managing money.

“[E]arlier screening and detection, combined with information about the risk of irreversible financial events, like foreclosure and repossession, are important to protect the financial well-being of the patient and their families,” Nicholas said.

The investigators found no link between increased missed payments or subprime credit scores before diagnosis of arthritis, glaucoma, or a hip fracture. And no long-term associations were found with heart attacks.

Full findings were published online Monday in JAMA Internal Medicine.