Chapter 19 - Financial Decision-Making and Capacity in Older Adults

Abstract

Financial capacity is an important instrumental activity of daily life that comprises those abilities needed for an individual independently to manage financial affairs in a manner consistent with personal self-interest and values. In this chapter, we examine the topic of financial capacity and decision-making in older adults in our aging society. Specifically, we discuss the crucial phenomenon of cognitive aging and diminished financial capacity, the impact on financial skills of cognitive disorders such as mild cognitive impairment (MCI) and Alzheimer’s disease (AD), and early warning signs of diminished financial capacity. We present a useful clinical conceptual model of financial capacity, describe different approaches to assessing financial capacity, and then discuss empirical studies of financial capacity in older adults with a focus on patients with MCI and AD. This chapter concludes with sections addressing exciting new neuroimaging investigations of financial decision-making and capacity, the importance of psychiatric and other non-cognitive contributions to financial capacity in aging, and directions for future research.