Milap A Nowrangi, Jeannie Marie Leoutsakos, Haijuan Yan, Arnold Bakker, Kevin J Manning, George W Rebok, Paul B Rosenberg, Vidyulata Kamath
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引用次数: 0
Abstract
Introduction: Financial capacity (FC) is the ability to independently manage finances in a manner consistent with one's self-interest. To investigate the relationship between FC, cognitive domains, neuropsychiatric symptoms, and transitions from normal cognition (cognitive normal [CN]) to mild cognitive impairment (MCI) or Alzheimer's disease (AD), we conducted a secondary analysis of the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort using the Financial Capacity Instrument short form (FCI-SF).
Methods: To examine these longitudinal relationships, we fit two models, a random effects (random intercept) "time-averaged" model and a "time since previous visit" model, where we regressed each of the five component financial scores on each of the cognitive composite scores. To examine the effect of baseline FCI-SF performance on conversion rates from normal to MCI or AD, we computed a survival model.
Results: A total of 874 participants (diagnostic group, N, mean age: CN: 501, 74.4; MCI: 319, 74.6; and AD 54, 74.9) were included in the analyses. In time since previous visit models, we found that lower executive function composite scores were related to decline in the complex checkbook score (ß = 1.35 (0.55), p = 0.016) and total completion time of the FCI-SF (ß = 1.85 (9.36), p = 0.025). In addition, lower composite visuospatial score was significantly related to poorer performance on financial conceptual knowledge, complex checkbook, and total completion time. Lower composite memory score was highly related to decline in financial conceptual knowledge, single checkbook, and bank statement subscale scores. ADNI participants in the lowest tertile of total completion time, at any point in time, were four times more likely to receive a diagnosis of MCI or AD compared to participants in the highest tertile with a hazard ratio of 4.22 ([2.29] p = 008).
Discussion: There is a multifaceted interaction between poorer cognition and everyday financial function where executive function, memory, and visuospatial cognition are related to FC. The strongest predictor of conversion from normal to either MCI or AD, appears to be time to completion.
Highlights: Decline in financial capacity (FC) is observed during transition to dementia and increases the risk of negative outcomes.Executive function, memory, and visuospatial cognition are related to FC.The strongest predictor of conversion from normal to either mild cognitive impairment (MCI) or Alzheimer's disease (AD) is time to completion or processing speed.
期刊介绍：
Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.
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