title: Structured assessment of mental capacity to make financial decisions in Chinese older persons with mild cognitive impairment and mild Alzheimer disease.
abstract: Previous studies suggested that patients with mild cognitive impairment (MCI) or dementia can have impaired and declining financial skills and abilities. The purpose of this study is to test a clinically applicable method, based on the contemporary legal standard, to examine directly the mental capacity to make financial decisions and its component decision-making abilities among patients with MCI and early dementia. A total of 90 patients with mild Alzheimer disease (AD), 92 participants with MCI, and 93 cognitively normal control participants were recruited for this study. Their mental capacity to make everyday financial decisions was assessed by clinician ratings and the Chinese version of the Assessment of Capacity for Everyday Decision-Making (ACED). Based on the clinician ratings, only 53.5% were found to be mentally competent in the AD group, compared with 94.6% in the MCI group. However, participants with MCI had mild but significant impairment in understanding, appreciating, and reasoning abilities as measured by the ACED. The ACED provided a reliable and clinically applicable structured framework for assessment of mental capacity to make financial decisions.
authors.affiliation: Department of Psychiatry, Tai Po Hospital, Hong Kong, Republic of China. victorluiwc@hotmail.com
authors.forename: Victor W C
authors.initials: VW
authors.lastname: Lui
authors.forename: Linda C W
authors.initials: LC
authors.lastname: Lam
authors.forename: Rachel C M
authors.initials: RC
authors.lastname: Chau
authors.forename: Ada W T
authors.initials: AW
authors.lastname: Fung
authors.forename: Billy M L
authors.initials: BM
authors.lastname: Wong
authors.forename: Grace T Y
authors.initials: GT
authors.lastname: Leung
authors.forename: K F
authors.initials: KF
authors.lastname: Leung
authors.forename: Helen F K
authors.initials: HF
authors.lastname: Chiu
authors.forename: Jason H T
authors.initials: JH
authors.lastname: Karlawish
authors.forename: Paul S
authors.initials: PS
authors.lastname: Appelbaum
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000523:psychology*; D003657:Decision Making; D005260:Female; D005382:Financing, Personal; D006723:Hong Kong; D006801:Humans; D008297:Male; D016743:Mental Competency / Q000523:psychology*; D009483:Neuropsychological Tests; D012720:Severity of Illness Index
keywords: ACED; Chinese; decision making; financial decisions; mental competency