Declining financial capacity in mild cognitive impairment: A 1-year longitudinal study.
OBJECTIVE
To investigate 1-year change in financial capacity in relation to conversion from amnestic mild cognitive impairment (MCI) to dementia.


METHODS
Seventy-six cognitively healthy older controls, 25 patients with amnestic MCI who converted to Alzheimer-type dementia during the study period (MCI converters), and 62 patients with MCI who did not convert to dementia (MCI nonconverters) were administered the Financial Capacity Instrument (FCI) at baseline and 1-year follow-up. Performance on the FCI domain and global scores was compared within and between groups using multivariate repeated-measures analyses.


RESULTS
At baseline, controls performed better than MCI converters and nonconverters on almost all FCI domains and on both FCI total scores. MCI converters performed below nonconverters on domains of financial concepts, cash transactions, bank statement management, and bill payment and on both FCI total scores. At 1-year follow-up, MCI converters showed significantly greater decline than controls and MCI nonconverters for the domain of checkbook management and for both FCI total scores. The domain of bank statement management showed a strong trend. For both the checkbook and bank statement domains, MCI converters showed declines in procedural skills, such as calculating the correct balance in a checkbook register, but not in conceptual understanding of a checkbook or a bank statement.


CONCLUSIONS
Declining financial skills are detectable in patients with mild cognitive impairment (MCI) in the year before their conversion to Alzheimer disease. Clinicians should proactively monitor patients with MCI for declining financial skills and advise patients and families about appropriate interventions.
Triebel
K L
KL
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL 35294-0017, USA.
Martin
R
R
Griffith
H R
HR
Marceaux
J
J
Okonkwo
O C
OC
Harrell
L
L
Clark
D
D
Brockington
J
J
Bartolucci
A
A
Marson
Daniel C
DC
D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000375:Aging; D003072:Cognition Disorders / Q000503:physiopathology / Q000523:psychology*; D015331:Cohort Studies; D003657:Decision Making; D003704:Dementia / Q000503:physiopathology / Q000523:psychology*; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005376:Financial Management; D015577:Geriatric Assessment; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008433:Mathematics; D016743:Mental Competency / Q000523:psychology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011340:Problem Solving; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012720:Severity of Illness Index