Financial Incapacity of Patients with Mild Alzheimer's Disease: What Neurologists Need to Know about Where the Impairment Lies.

Vaitsa Giannouli,Magda Tsolaki

doi:10.3390/neurolint14010008

Vaitsa Giannouli, Magda Tsolaki

Open Access

https://doi.org/10.3390/neurolint14010008

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Journal: Neurology international	Publication Date: Jan 11, 2022
Citations: 10	License type: CC BY 4.0

Affiliation: Aristotle University of Thessaloniki

Abstract

Research in the last decade has focused on assessing financial capacity and incapacity mainly in old age, but new research has turned to address the question of how financial incapacity can be predicted by cognitive factors. The aim of this study was to identify which cognitive domains predict financial capacity and the relevant cognitive skills of patients with mild Alzheimer’s disease (AD) in order to assist neurologists in functional assessment and further patient referral. In this study, 109 patients diagnosed with mild AD were examined with a number of neuropsychological tests: Mini-Mental State Examination (MMSE), Functional Rating Scale for Symptoms of Dementia (FRSSD), Functional Cognitive Assessment Scale (FUCAS), Trail Making Test (TMT)-Part B, Rey-Osterrieth Complex Figure Test (ROCFT)-copy condition and delayed recall condition, Rey Auditory Verbal Learning Test (RAVLT), Boston Naming Test, Rivermead Behavioural Memory Test (RBMT), digit span forward and backward, WAIS-R digit symbol substitution test, Neuropsychiatric Inventory (NPI), Geriatric Depression Scale (GDS-15), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). LCPLTAS total score and relevant subdomains were best predicted only by the score of one item coming from MMSE: subtraction of serial sevens. This is the only measure of arithmetic testing in use for the Greek geriatric population. Financial capacity is severely impaired in the group of mild AD patients. In order to prevent financial exploitation cases, neurologists, neuropsychologists, psychiatrists, and geriatrists should pay close attention to the information from the relevant arithmetic question of MMSE, as it is one of the most widely administered screening tests in clinical settings.

Highlights

Alzheimer’s disease (AD)is often diagnosed in the mild dementia stage, which is characterized by significant cognitive decline that interferes with the independence of the person
Pearson correlations revealed that the LCPTLAS full scale total score correlated significantly with the years of education (r = 0.421, p < 0.001) a finding that is supported by prior relevant research [22], as well as with Mini-Mental State Examination (MMSE) (r = 0.487, p < 0.001), Rivermead Behavioural Memory Test (RBMT) delayed recall (r = 0.213, p = 0.036), Trail Making Test Part B (r = −0.494, p < 0.001), Rey-Osterrieth Complex Figure Test (ROCFT)-copy condition (r = 0.313, p = 0.002), WAIS-R digit symbol substitution test (r = 0.292, p = 0.011), and the arithmetic question score from MMSE (r = 0.750, p < 0.001)
The neuropsychological measures entered in the regression were those that correlated significantly with the LCPTLAS full scale, and they were used because they cover broad areas of cognitive functioning

Summary

Introduction

Alzheimer’s disease (AD)is often diagnosed in the mild dementia stage, which is characterized by significant cognitive decline that interferes with the independence of the person. Research has demonstrated that loss of financial capacity is a common consequence of AD [2], and of Parkinson’s disease [3], vascular dementia [4], frontotemporal dementia [5], and even amnestic Mild Cognitive Impairment (aMCI) [6]. One problem is that written arithmetic skills are not currently examined with the use of a standardized test for the older Greek population ( rendering impossible the use of relevant neuropsychological tests in clinical practice in Greece).

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