title: Financial errors in dementia: testing a neuroeconomic conceptual framework.
abstract: Financial errors by patients with dementia can have devastating personal and family consequences. We developed and evaluated a neuroeconomic conceptual framework for understanding financial errors across different dementia syndromes, using a systematic, retrospective, blinded chart review of demographically-balanced cohorts of patients with Alzheimer's disease (AD, n=100) and behavioral variant frontotemporal dementia (bvFTD, n=50). Reviewers recorded specific reports of financial errors according to a conceptual framework identifying patient cognitive and affective characteristics, and contextual influences, conferring susceptibility to each error. Specific financial errors were reported for 49% of AD and 70% of bvFTD patients (p = 0.012). AD patients were more likely than bvFTD patients to make amnestic errors (p < 0.001), while bvFTD patients were more likely to spend excessively (p = 0.004) and to exhibit other behaviors consistent with diminished sensitivity to losses and other negative outcomes (p < 0.001). Exploratory factor analysis identified a social/affective vulnerability factor associated with errors in bvFTD, and a cognitive vulnerability factor associated with errors in AD. Our findings highlight the frequency and functional importance of financial errors as symptoms of AD and bvFTD. A conceptual model derived from neuroeconomic literature identifies factors that influence vulnerability to different types of financial error in different dementia syndromes, with implications for early diagnosis and subsequent risk prevention.
authors.affiliation: a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , United States.
authors.forename: Winston
authors.initials: W
authors.lastname: Chiong
authors.forename: Ming
authors.initials: M
authors.lastname: Hsu
authors.forename: Danny
authors.initials: D
authors.lastname: Wudka
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Miller
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Rosen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000191:economics / Q000523:psychology; D003657:Decision Making / Q000502:physiology; D003704:Dementia / Q000191:economics* / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D057180:Frontotemporal Dementia / Q000191:economics / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D008960:Models, Psychological; D009415:Nerve Net / Q000502:physiology*; D012189:Retrospective Studies
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