Financial capacity is already significantly impaired in mild AD. Patients with mild AD demonstrate deficits in more complex financial abilities and impairment in most financial activities. Patients with moderate AD demonstrate severe impairment of all financial abilities and activities. The Financial Capacity Instrument has promise as an instrument for assessing domain-level financial activities and task-specific financial abilities in patients with dementia. Arch Neurol. 2000.
Recent research has demonstrated that loss of ®nancial capacity is a common consequence of Alzheimer's disease (AD). While progressive cognitive decline is a de®ning feature of AD, the relationship between such decline and loss of ®nancial capacity in AD remains unclear. Working memory may be strongly associated with ®nancial abilities, as many ®nancial tasks require temporary storage and manipulation of numerical and other data. The present study examined the relationship between ®nancial capacity and working memory in AD patients. Participants included 20 AD patients and 23 cognitively intact older controls. Working memory was conceptualized using Baddeley and colleagues' model, which posits that the three components of the working memory system are the visuospatial sketchpad, phonological loop, and central executive system. The present study examined only the latter two components of working memory. Each participant was administered the Financial Capacity Instrument (FCI), an instrument that directly assesses eight domains of ®nancial activity, and the WAIS-III Working Memory subtests (Digit Span, Arithmetic, Letter±Number Sequencing). AD patients as a group performed signi®cantly below controls on the FCI Total Score and on each of the eight FCI domains and working memory subtests. Within the AD group, measures of the central executive component of working memory (WAIS-III Digits Backward, Arithmetic, and Letter-Number Sequencing tests) showed strong correlations with the FCI domains of basic monetary skills, checkbook management, bank statement management, and bill payment and FCI total score, while a measure of the phonological loop component of working memory (WAIS-III Digits Forward) was not signi®cantly correlated with any FCI domains or with the FCI total score. The results suggest that the multiple domains of ®nancial capacity are primarily correlated with the central executive component of working memory.Loss of ®nancial abilities is a common consequence of Alzheimer's disease (AD) . While progressive cognitive decline is a de®ning feature of AD, the relationship between such decline and loss of ®nancial capacity in AD remains unclear. Research identifying cognitive correlates of declining ®nancial abilities can enhance our scienti®c understanding of the neurological substrates of ®nancial competency loss in dementia, and can inform clinical assessment of ®nancial skills by identifying speci®c cognitive impairments associated with ®nancial competency loss.Working memory is one speci®c domain of cognitive function that may be strongly associated with loss of ®nancial abilities in AD. Working memory is broadly de®ned as the temporary storage and manipulation of information (Smith
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