title: MRI volume of the medial frontal cortex predicts financial capacity in patients with mild Alzheimer's disease.
abstract: Persons with mild Alzheimer's disease (AD) have significant deficits in financial abilities. This study examined the relationship between brain structure volumes, cognition, and financial capacity in patients with mild AD. Sixteen mild AD patients and 16 older adult comparisons completed the Financial Capacity Instrument (FCI), a psychometric measure of financial abilities, and also underwent magnetic resonance imaging (MRI) to obtain volumes of the bilateral hippocampi, angular gyri, precunei, and medial and dorsolateral frontal cortices. Mild AD patients performed significantly below comparisons on the FCI and had significantly smaller hippocampi. Among mild AD patients, FCI performance was moderately correlated with frontal (medial and dorsolateral frontal cortex) and posterior (angular gyri and precunei) cortical volumes. Stepwise regression demonstrated that medial frontal cortex volume predicted FCI score. The relationship between medial frontal cortex volume and overall FCI score was partially mediated by two measures of simple attention (DRS Attention, DRS Construction). The findings suggest that medial frontal cortex atrophy and associated declines in simple attention play an increasingly important role in declining financial skills in patients with mild AD.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA, lstoeckel@partners.org.
authors.forename: Luke E
authors.initials: LE
authors.lastname: Stoeckel
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Stewart
authors.forename: H Randall
authors.initials: HR
authors.lastname: Griffith
authors.forename: Kristen
authors.initials: K
authors.lastname: Triebel
authors.forename: Ozioma C
authors.initials: OC
authors.lastname: Okonkwo
authors.forename: Jan A
authors.initials: JA
authors.lastname: den Hollander
authors.forename: Roy C
authors.initials: RC
authors.lastname: Martin
authors.forename: Katherine
authors.initials: K
authors.lastname: Belue
authors.forename: Jacquelynn N
authors.initials: JN
authors.lastname: Copeland
authors.forename: Lindy E
authors.initials: LE
authors.lastname: Harrell
authors.forename: John C
authors.initials: JC
authors.lastname: Brockington
authors.forename: David G
authors.initials: DG
authors.lastname: Clark
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Marson
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D060825:Cognitive Dysfunction / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D058245:Cognitive Reserve; D003657:Decision Making; D005260:Female; D005382:Financing, Personal; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic