Financial capacity in frontotemporal dementia and related presentations

Abstract

Background Changes in financial judgement and skills can herald a neurodegenerative dementia and are a common reason for referral for cognitive neurologic assessment. However, patients with neurodegenerative diseases affecting the frontal or temporal lobes may perform well on standard cognitive tests, complicating clinical determinations about their diagnosis and financial capacity. Methods Forty-five patients with possible or probable FTD or Alzheimer’s disease and 22 healthy controls completed two financial assessment batteries, the FACT and the FCAI. Patients’ performance was compared to study partner estimates of patients’ financial abilities. Results All three patient groups performed worse than controls on both the FACT and the FCAI. Study partners over-estimated the performance of patients with Alzheimer’s disease. Conclusions These initial findings suggest that accurate clinical assessment of financial skills and judgement in patients with possible neurodegenerative dementias requires performance-based assessment. Electronic supplementary material The online version of this article (10.1007/s00415-019-09317-w) contains supplementary material, which is available to authorized users.

The neglected contributions of self-efficacy to older adults’ financial capacity

“…Unfortunately, dependency itself creates opportunities for financial exploitation (Peterson et al, 2014), which does little to resolve issues associated with impaired financial capacity. However, this line of enquiry has highlighted the susceptibility of financial capacity to pathological changes associated with Parkinson's disease, Alzheimer's disease and related dementia (Marson, 2013;Marson et al, 2000;Gill et al, 2019).…”

“…The second area of research focusses on developing and assessing multidimensional measures of financial capacity (Ghesquiere et al, 2019;Gill et al, 2019;Caboral-Stevens and Medetsky, 2014;Lichtenberg et al, 2015;Marson et al, 2000;Gardiner et al, 2015;Gerstenecker, 2016;Barrett et al, 2009). Despite commendable efforts, there is no widely accepted definition and measure of financial capacity (Marson et al, 2016;Pinsker et al, 2010).…”

Can we afford this? The capability to make financial decisions in individuals with and without cognitive impairment

“…Scores on all domains separately and an overall total score can be calculated, with higher scores indicating a better FDM capacity. The FACT is used in one study included in the review (i.e., Gill et al, 2019). 4.…”

“…Higher scores indicate a better knowledge and understanding of financial competence. The FCAI is used in two studies included in this review (i.e., Gill et al, 2019;. 5.…”

“…Most studies included people living with AD who were in a mild and/or moderate stage of the disease, two studies also included a group of people in a severe stage of AD . Seven studies, however, did not specify the stage of the disease (Gill et al, 2019;Lima-Silva et al, 2015;Loewenstein et al, 1989.…”