Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-22T06:02:54.509Z Has data issue: false hasContentIssue false
  • English
  • Français

Neurocognitive predictors of financial capacity across the dementia spectrum: Normal aging, mild cognitive impairment, and Alzheimer’s disease

Published online by Cambridge University Press:  01 March 2009

MEGAN G. SHEROD ,
H. RANDALL GRIFFITH ,
JACQUELYNN COPELAND ,
KATHERINE BELUE ,
SARA KRZYWANSKI ,
EDWARD Y. ZAMRINI ,
LINDY E. HARRELL ,
DAVID G. CLARK ,
JOHN C. BROCKINGTON  and
RICHARD E. POWERS
...Show all authors
MEGAN G. SHEROD
Affiliation:
Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, Alabama
H. RANDALL GRIFFITH
Affiliation:
Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, Alabama
JACQUELYNN COPELAND
Affiliation:
Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, Alabama
KATHERINE BELUE
Affiliation:
Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama
SARA KRZYWANSKI
Affiliation:
Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, Alabama
EDWARD Y. ZAMRINI
Affiliation:
Department of Neurology, University of Utah, Salt Lake City, Utah
LINDY E. HARRELL
Affiliation:
Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, Alabama Veterans Administration Medical Center, Birmingham, Alabama
DAVID G. CLARK
Affiliation:
Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, Alabama Veterans Administration Medical Center, Birmingham, Alabama
JOHN C. BROCKINGTON
Affiliation:
Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, Alabama
RICHARD E. POWERS
Affiliation:
Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, Alabama Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama State of Alabama Department of Mental Health and Mental Retardation, Montgomery, Alabama
DANIEL C. MARSON*
Affiliation:
Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, Alabama
*
*Correspondence and reprint requests to: Daniel C. Marson, Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7th Avenue South, Birmingham, Alabama 35294-0017. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Financial capacity is a complex instrumental activity of daily living critical to independent functioning of older adults and sensitive to impairment in patients with amnestic mild cognitive impairment (MCI) and Alzheimer’s disease (AD). However, little is known about the neurocognitive basis of financial impairment in dementia. We developed cognitive models of financial capacity in cognitively healthy older adults (n = 85) and patients with MCI (n = 113) and mild AD (n = 43). All participants were administered the Financial Capacity Instrument (FCI) and a neuropsychological test battery. Univariate correlation and multiple regression procedures were used to develop cognitive models of overall FCI performance across groups. The control model (R2 = .38) comprised (in order of entry) written arithmetic skills, delayed story recall, and simple visuomotor sequencing. The MCI model (R2 = .69) comprised written arithmetic skills, visuomotor sequencing and set alternation, and race. The AD model (R2 = .65) comprised written arithmetic skills, simple visuomotor sequencing, and immediate story recall. Written arithmetic skills (WRAT-3 Arithmetic) was the primary predictor across models, accounting for 27% (control model), 46% (AD model), and 55% (MCI model) of variance. Executive function and verbal memory were secondary model predictors. The results offer insight into the cognitive basis of financial capacity across the dementia spectrum of cognitive aging, MCI, and AD. (JINS, 2009, 15, 258–267.)

Keywords

Financial capacityIADLsCognitive predictorsCognitive agingMCIAD
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 15 , Issue 2 , March 2009 , pp. 258 - 267
Copyright
Copyright © INS 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Benton, A.L. & Hamsher, K. (1983). Multilingual aphasia examination. Iowa City, IA: AJA Associates.Google Scholar
Butters, M., Salmon, D., & Butters, N. (1994). Neuropsychological assessment of dementia. In Storandt, M. & VandenBos, G. (Eds.), Neuropsychological assessment of dementia and depression in older adults: A clinician’s guide (pp. 33–59). Washington, DC: American Psychological Association.Google Scholar
Carlomagno, S., Iavarone, A., Nolfe, G., Bourene, G., Martin, C., & Deloche, G. (1999). Dyscalculia in the early stages of Alzheimer’s disease. Acta Neurologica Scandinavica, 99, 166–174.Google Scholar
Conners, K. (2000). Conners’ Continuous Performance Test-II. North Tonawanda, NY: Multi-Health Systems Inc.Google Scholar
Cosentino, S., Manly, J., & Mungas, D. (2007). Do reading tests measure the same construct in multiethnic and multilingual older persons? Journal of the International Neuropsychological Society, 13, 228–236.Google Scholar
Cullum, C.M., Saine, K., Chan, L.D., Martin-Cook, K., Gray, K.F., & Weiner, M.F. (2001). Performance-based instrument to assess functional capacity in dementia: The Texas Functional Independent Living Scale. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 14, 103–108.Google Scholar
Delis, D.C., Kramer, J.H., Kaplan, E., & Ober, B.A. (2000). California Verbal Learning Test—Second Edition—Adult version. New York: The Psychological Corporation.Google Scholar
Deloche, G., Hannequin, D., & Carlomagno, S. (1995). Calculation and number processing in mild Alzheimer’s disease. Journal of Clinical and Experimental Neuropsychology, 17, 634–639.Google Scholar
Earnst, K., Wadley, V., Aldridge, T., Steenwyk, A., Hammond, A., Harrell, L., & Marson, D. (2001). Loss of financial capacity in Alzheimer’s disease: The role of working memory. Aging, Neuropsychology, and Cognition, 8, 109–119.Google Scholar
Farias, S.T., Harrell, E., Neumann, C., & Houtz, A. (2003). The relationship between neuropsychological performance and daily functioning in individuals with Alzheimer’s disease: Ecological validity of neuropsychological tests. Archives of Clinical Neuropsychology, 18(6), 655–672.CrossRefGoogle ScholarPubMed
Folstein, M., Folstein, S., & McHugh, P. (1975). Mini-Mental State: A practical guide for grading the cognitive state of the patient for the physician. Journal of Psychiatry Research, 12, 189–198.Google Scholar
Girelli, L. & Delazer, M. (2001). Numerical abilities in dementia. Aphasiology, 15, 681–694.Google Scholar
Griffith, H.R., Belue, K., Sicola, A., Krzywanski, S., Zamrini, E., Harrell, L., & Marson, D.C. (2003). Impaired financial abilities in mild cognitive impairment: A direct assessment approach. Neurology, 60(3), 449–457.Google Scholar
Jurica, P.J., Leitten, C.L., & Mattis, S. (2001). DRS-2 Dementia Rating Scale-2. Lutz, FL: Psychological Assessment Resources Inc.Google Scholar
Kaplan, E., Goodglass, H., & Weintraub, S. (1983). Boston Naming Test. Philadelphia, PA: Lea & Febiger.Google Scholar
Lezak, M.D. (1995). Neuropsychological assessment (3rd ed). New York: Oxford University Press.Google Scholar
Lezak, M.D., Howieson, D.B., & Loring, D.W. (2004). Neuropsychological assessment (4th ed). New York: Oxford University Press.Google Scholar
Mahurin, R.K., DeBettignies, B.H., & Pirozzolo, F.J. (1991). Structured assessment of independent living skills: Preliminary report of a performance measure of functional abilities in dementia. Journal of Gerontology, 46, P58–P66.Google Scholar
Manly, J.J., Jacobs, D.M., Touradji, P., Small, S.A., & Stern, Y. (2002). Reading level attenuates differences in neuropsychological test performance between African American and White elders. Journal of the International Neuropsychological Society, 8, 341–348.Google Scholar
Marson, D. (2001). Loss of financial capacity in dementia: Conceptual and empirical approaches. Aging, Neuropsychology and Cognition, 8, 164–181.Google Scholar
Marson, D., Martin, R., Wadley, V., Griffith, H.R., Snyder, S., Goode, P.S., Kinney, F.C., Nicholas, A.P., Steele, T., Anderson, B., Zamrini, E., Raman, R., Bartolucci, A., & Harrell, L.E. (in press). Clinical interview assessment of financial capacity in older adults with mild cognitive impairment and Alzheimer’s disease.Google Scholar
Marson, D., Sawrie, S., Snyder, S., McInturff, B., Stalvey, T., Boothe, A., Aldridge, T., Chatterjee, A., & Harrell, L. (2000). Assessing financial capacity in patients with Alzheimer’s disease: A conceptual model and prototype instrument. Archives of Neurology, 57, 877–884.Google Scholar
Martin, R., Griffith, H.R., Belue, K., Harrell, L., Zamrini, E., Anderson, B., Bartolucci, A., & Marson, D. (2008). Declining financial capacity in patients with mild Alzheimer disease: A one-year longitudinal study. American Journal of Geriatric Psychiatry, 16(3), 209–219.Google Scholar
Martin, R.C., Annis, S.M., Darling, L.Z., Wadley, V., Harrell, L., & Marson, D.C. (2003). Loss of calculation abilities in patients with mild and moderate Alzheimer disease. Archives of Neurology, 60(11), 1585–1589.Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E. (1984). Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA work group under the auspices of the Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology, 34, 939–944.Google Scholar
Melton, G., Petrila, J., Poythress, N., & Slobogin, C. (1987). Psychological evaluations for the courts. New York: Guilford Press.Google Scholar
Morris, J. (1993). The Clinical Dementia Rating (CDR): Current version and scoring rules. Neurology, 43, 2412–2414.Google Scholar
Okonkwo, O.C., Griffith, H.R., Belue, K., Lanza, S., Zamrini, E.Y., Harrell, L.E., Brockington, J.C., Clark, D., Raman, R., & Marson, D.C. (2008). Cognitive models of medical decision-making capacity in patients with mild cognitive impairment. Journal of the International Neuropsychological Society, 14, 297–308.Google Scholar
Okonkwo, O.C., Wadley, V.G., Griffith, H.R., Ball, K., & Marson, D. (2006). Cognitive correlates of financial abilities in mild cognitive impairment. Journal of the American Geriatrics Society, 54, 1745–1750.Google Scholar
Parlato, V., Lopez, O., Panisset, M., Iavarone, A., Grafman, J., & Boller, F. (1992). Mental calculation in mild Alzheimer’s disease: A pilot study. International Journal of Geriatric Psychiatry, 7, 599–602.Google Scholar
Pasquier, F. (1999). Early diagnosis of dementia: Neuropsychology. Journal of Neurology, 246(1), 6–15.Google Scholar
Perneczky, R., Pohl, C., Sorg, C., Hartmann, J., Tosic, N., Grimmer, T., Heitele, S., & Kurz, A. (2006). Impairment of activities of daily living requiring memory or complex reasoning as part of the MCI syndrome. International Journal of Geriatric Psychiatry, 21, 158–162.Google Scholar
Petersen, R.C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256(3), 183–194.Google Scholar
Petersen, R.C., Doody, R., Kurz, A., Mohs, R.C., Morris, J.C., Rabins, P.V., Ritchie, K., Rossor, M., Thal, L., & Winblad, B. (2001a). Current concepts in mild cognitive impairment. Archives of Neurology, 58(12), 1985–1992.Google Scholar
Petersen, R.C., Smith, G.E., Waring, S.C., Ivnik, R.J., Tangalos, E.G., & Kokmen, E. (1999). Mild cognitive impairment: Clinical characterization and outcome. Archives of Neurology, 56(3), 303–308.Google Scholar
Petersen, R.C., Stevens, J.C., Ganguli, M., Tangalos, E.G., Cummings, J.L., & DeKosky, S.T. (2001b). Practice parameter: Early detection of dementia: Mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 56(9), 1133–1142.Google Scholar
Reitan, R.M. & Wolfson, D. (1993). The Halstead-Reitan Neuropsychological Test Battery: Theory and clinical interpretation. Tucson, AZ: Neuropsychology Press.Google Scholar
Ribeiro, F., de Mendonca, A., & Guerreiro, M. (2006). Mild cognitive impairment: Deficits in cognitive domains other than memory. Dementia and Geriatric Cognitive Disorders, 21, 284–290.CrossRefGoogle ScholarPubMed
Rosselli, M., Ardila, A., Arvizu, L., Kretzmer, T., Standish, V., & Liebermann, J. (1998). Arithmetical abilities in Alzheimer disease. International Journal of Neuroscience, 96(3–4), 141–148.Google Scholar
Royall, D.R., Cordes, J.A., & Polk, M. (1998). CLOX: An executive clock drawing task. Journal of Neurology, Neurosurgery, and Psychiatry, 64(5), 588–594.Google Scholar
Santillan, C.E., Fritsch, T., & Geldmacher, D.S. (2003). Development of a scale to predict decline in patients with mild Alzheimer’s disease. Journal of the American Geriatrics Society, 51, 91–95.CrossRefGoogle ScholarPubMed
Spreen, O. & Strauss, E. (1991). A compendium of neuropsychological tests. New York: Oxford University Press.Google Scholar
SPSS Inc. (2007). SPSS base 16.0 applications guide. Chicago, IL: SPSS Inc.Google Scholar
Wang, P.L. & Ennis, K.E. (1986). The Cognitive Competency Test. Toronto, Ontario: Mt. Sinai Hospital Neuropsychology Laboratory.Google Scholar
Wechsler, D. (1987). Wechsler Memory Scale—Revised Edition. San Antonio, TX: Psychological Corporation.Google Scholar
Wechsler, D. (1997a). Wechsler Adult Intelligence Scale—Third Edition. New York: Psychological Corporation.Google Scholar
Wechsler, D. (1997b). Wechsler Memory Scale—Third Edition. New York: Psychological Corporation.Google Scholar
Wilkinson, G.S. (1993). The Wide Range Achievement Test—Third Edition—Administration manual. Wilmington, DE: JASTAK.Google Scholar