Payment delinquencies on mortgages and credit cards emerge as measurable indicators of cognitive decline occurring years before clinical dementia diagnosis becomes apparent. This NIA-funded research identifies financial management deterioration as among the earliest detectable signs of neurodegeneration, preceding traditional cognitive assessments. The finding represents a significant advance in early detection methodology, as financial tasks require complex executive function including working memory, planning, and numerical processing—cognitive domains that deteriorate early in Alzheimer's progression. Unlike subjective memory complaints or subtle cognitive changes that families might dismiss, financial records provide objective, timestamped evidence of declining function. This approach could revolutionize screening protocols, particularly valuable given that effective interventions show greatest promise when initiated during preclinical stages. The research suggests routine monitoring of financial patterns could identify at-risk individuals years before current diagnostic methods, potentially enabling earlier lifestyle interventions, medication trials, and care planning. However, the approach requires careful consideration of confounding factors including economic hardship, life stressors, or medical expenses that might also affect payment patterns. While promising for population screening, implementation would need safeguards against misinterpretation and premature alarm.