title: Impaired financial abilities in Parkinson's disease patients with mild cognitive impairment and dementia.
abstract: OBJECTIVE
  Financial capacity (FC) is an instrumental activity of daily living (IADL) critical to independent functioning and sensitive to cognitive impairment in dementia. Little is known about FC in cognitively impaired patients with Parkinson's disease (PD). The present study investigated FC in PD patients with prodromal and clinical dementia.
  
  
  METHODS
  Participants were 20 older controls and 35 PD patients who met consensus criteria for either mild cognitive impairment (PD-MCI, n = 18) or PD dementia (PDD, n = 17). FC was assessed using a standardized performance based measure consisting of 9 domain and two global scores (Financial Capacity Instrument; FCI) (1). FCI domain and global performance scores were compared across groups. Capacity impairment ratings (no impairment, mild/moderate impairment, severe impairment) were calculated for each PD patient's domain and global scores.
  
  
  RESULTS
  Relative to controls, PD-MCI patients were impaired on both FCI global scores and domains of basic monetary skills, financial concepts, and investment decision-making. Relative to both controls and PD-MCI patients, PDD patients were impaired on virtually all FCI variables. With respect to impairment ratings, greater than 50% of PD-MCI patients and greater than 90% of PDD patients were classified as either mild/moderate or severely impaired on the two FCI global scores.
  
  
  CONCLUSIONS
  Impairment of financial capacity is already present in PD-MCI and is advanced in PDD. Complex cognitively-mediated IADLs such as financial capacity appear to be impaired early in the course of PD dementia.
authors.affiliation: Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; Alzheimer's Disease Research Center, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Roy C
authors.initials: RC
authors.lastname: Martin
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Triebel
authors.forename: Richard E
authors.initials: RE
authors.lastname: Kennedy
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Nicholas
authors.forename: Ray L
authors.initials: RL
authors.lastname: Watts
authors.forename: Natividad P
authors.initials: NP
authors.lastname: Stover
authors.forename: Mariko
authors.initials: M
authors.lastname: Brandon
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Marson
mesh_terms: D000368:Aged; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000191:economics / Q000523:psychology*; D003657:Decision Making / Q000502:physiology; D003704:Dementia / Q000175:diagnosis / Q000191:economics / Q000523:psychology; D005260:Female; D005382:Financing, Personal; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000191:economics / Q000523:psychology*
keywords: Financial ability; Functional change; MCI (mild cognitive impairment); Parkinson's disease with dementia; Parkinson's disease/parkinsonism
references.citation: Neurology. 2003 Feb 11;60(3):449-57
references.pmid: 12578926
references.citation: Gerontologist. 1969 Autumn;9(3):179-86
references.pmid: 5349366
references.citation: Mov Disord. 2007 Jul 30;22(10):1430-1435
references.pmid: 17534944
references.citation: Am J Geriatr Psychiatry. 2008 Mar;16(3):209-19
references.pmid: 18263665
references.citation: Mov Disord. 2007 Jul 15;22(9):1272-7
references.pmid: 17415797
references.citation: Arch Clin Neuropsychol. 1998 Oct;13(7):575-83
references.pmid: 14590618
references.citation: Dement Geriatr Cogn Disord. 2007;24(5):327-34
references.pmid: 17851237
references.citation: Mov Disord. 2007 Sep 15;22(12):1689-707; quiz 1837
references.pmid: 17542011
references.citation: Arch Neurol. 2000 Jun;57(6):877-84
references.pmid: 10867786
references.citation: Mov Disord. 2012 Mar;27(3):349-56
references.pmid: 22275317
references.citation: Mov Disord. 2008 Oct 15;23(13):1867-74
references.pmid: 18759361
references.citation: Neurology. 2009 Sep 22;73(12):928-34
references.pmid: 19770468
references.citation: Mov Disord. 2008 Apr 30;23(6):790-6
references.pmid: 18361474
references.citation: Mov Disord. 2007 Dec;22(16):2314-24
references.pmid: 18098298
references.citation: J Int Neuropsychol Soc. 2003 Jan;9(1):17-24
references.pmid: 12570354
references.citation: Neurology. 2007 Mar 13;68(11):812-9
references.pmid: 17353469
references.citation: Parkinsonism Relat Disord. 2005 Aug;11(5):311-5
references.pmid: 15886042
references.citation: Arch Neurol. 1993 Feb;50(2):140-8
references.pmid: 8431132
references.citation: Dement Geriatr Cogn Disord. 2003;15(3):126-31
references.pmid: 12584427
references.citation: Neurology. 2005 Aug 9;65(3):483-5
references.pmid: 16087924
references.citation: J Neurol Neurosurg Psychiatry. 2007 Apr;78(4):363-6
references.pmid: 17178820
references.citation: J Psychiatr Res. 1982-1983;17(1):37-49
references.pmid: 7183759
references.citation: J Am Geriatr Soc. 2004 May;52(5):784-8
references.pmid: 15086662
references.citation: J Intern Med. 2004 Sep;256(3):240-6
references.pmid: 15324367
references.citation: Neurology. 1993 Nov;43(11):2412-4
references.pmid: 8232972