Is Depression or Apathy Playing a Key Role in Predicting Financial Capacity in Parkinson’s Disease with Dementia and Frontotemporal Dementia?

Abstract

(1) Background: Depression and apathy both affect cognitive abilities, such as thinking, concentration and making decisions in young and old individuals. Although apathy is claimed to be a “core” feature of Parkinson’s disease (PD) and frontotemporal dementia (FTD), it may occur in the absence of depression and vice versa. Thus, the aim of this study is to explore whether depression or apathy better predict financial capacity performance in PD and FTD as well as in nondemented participants. (2) Methods: Eighty-eight participants divided into three groups (PD, FTD and non-demented participants) were examined with the Mini-Mental State Examination (MMSE) and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS)—Full and short form. The Geriatric Depression Scale informant version (GDS-15) and the Irritability-Apathy Scale (IAS) we completed by caregivers. (3) Results: The results indicated that both PD and FTD patients’ general cognitive functioning and financial capacity performance is negatively influenced by apathy and not by depression. (4) Conclusions: Differences in financial capacity performance indicate that apathy should not be disregarded in clinical assessments. Further studies on larger PD and FTD populations are necessary in order to investigate the decisive role of mood factors on financial capacity impairment.

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

“…The sample consisted of patients with a diagnosis of mild AD, so generalizations to other stages and types of neurocognitive disorders is impossible. In addition to that, although depression was included as a possible confounder (depressive symptoms were measured by the GDS-15), apathy (which has been found to be important in financial capacity in Parkinson’s Disease with dementia and frontotemporal dementia [ 27 ]) was not measured, as it was not included in the standard examination protocol of the hospital.…”

Financial Capacity and Illiteracy: Does Education Matter in Amnestic Mild Cognitive Impairment?

“…Although illiteracy seems to have a disastrous influence similar to the detrimental influence of depression on financial capacity in Parkinson’s disease and vascular dementia [ 2–4 ], further research should clarify the exact components of the influence of schooling background on neuropsychological test performance and how it can affect cognitive performance [ 20 ] as well as other variables such as prior financial experiences due to job before retirement, while the role of gender should be examined in larger samples of men as well as women. One more point that could be further investigated is the role not only of cognitive, but also emotional factors, since depression, anxiety, and apathy are common in MCI patients [ 21 ], and financial capacity has been found to be influenced by apathy more than depression in Parkinson’s disease with dementia and frontotemporal dementia [ 22 ].…”

Liberating older adults from the bonds of vascular risk factors: What is their impact on financial capacity in amnestic mild cognitive impairment?

“…6,7 Financial capacity so far has been examined in patients with Parkinson disease, 10 multiple-domain aMCI, 11 frontotemporal dementia, 12 vascular dementia 3 and mild Alzheimer disease. 14 All of these studies support that depression has detrimental effects on financial capacity, [10][11][12][13][14] but other studies also support the influence of additional factors such as psychological (apathy), 15 biological (left angular gyrus and amygdala brain volumes), 16 and educational (literacy) aspects, 17 but not genetic (APOE ϵ4 gene) aspects 18 or cerebrospinal fluid biomarkers (amyloid β peptide 1-42, total tau, and phosphorylated tau concentrations). 19 Taking into consideration previous studies showing that vascular burden and, more specifically, the number of multiple VRFs and diseases increase the amount of executive impairment in patients with aMCI similar to what has been repeatedly reported in healthy older adults, [20][21][22] this study aims to elucidate whether the two subtypes of aMCI, 23 ie, patients with single-domain aMCI who experience only isolated memory deficit and patients with multiple-domain aMCI who experience memory deficits plus deficits in other cognitive domains, most often executive, first present with the same frequency of VRFs, and second whether financial capacity can be affected by the cumulative effects of multiple VRFs in the two subtypes of aMCI.…”

“…Financial capacity so far has been examined in patients with Parkinson disease, 10 multiple‐domain aMCI, 11 frontotemporal dementia, 12 vascular dementia 3 and mild Alzheimer disease 14 . All of these studies support that depression has detrimental effects on financial capacity, 10–14 but other studies also support the influence of additional factors such as psychological (apathy), 15 biological (left angular gyrus and amygdala brain volumes), 16 and educational (literacy) aspects, 17 but not genetic (APOE ɛ4 gene) aspects 18 or cerebrospinal fluid biomarkers (amyloid β peptide 1–42, total tau, and phosphorylated tau concentrations) 19…”