Financial abuse, currently the most common form of elder abuse, is estimated to affect one in five older adults. Financial abuse frequently occurs along with other types of abuse and neglect and according to experts is often the gateway to other forms of abuse. Declining mental capabilities related to aging make older adults more vulnerable to financial scams and undue influence. A newly described phenomenon of Age-associated Financial Vulnerability is being described in older adults with and without cognitive impairment and is an area of active research. Many factors other than dementia, often in combination with each other and dementia, increase the risk of financial vulnerability including depression, social isolation and loneliness, and sensory or physical impairments. Older patients or clients who display changes in financial decision-making abilities that place them at risk for declining quality of life, should have a complete medical and psychological evaluation to ensure that decisions they are making are done with full decisional ability.