Martin Roy C, Gerstenecker Adam, Triebel Kristen L, Falola Michael, McPherson Tarrant, Cutter Gary, Marson Daniel C
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA.
Arch Clin Neuropsychol. 2019 Mar 1;34(2):152-161. doi: 10.1093/arclin/acy030.
To investigate financial skill decline over a 6-year period in persons with mild cognitive impairment (MCI) presumed due to Alzheimer's disease (AD).
Study participants were cognitively normal (CN) older adults (n = 82) and adults with MCI (n = 91) based on consensus conference diagnosis. Participants completed baseline and up to six annual follow-up assessments that included standardized financial skills measurement (Financial Capacity Instrument; FCI; nine FCI domain and two global scores). We examined FCI change over time using mixed-model repeated measures analysis adjusted for baseline age and follow-up duration.
At baseline, the CN group performed better than the MCI group across both global and seven domain scores. Group × Time interaction effects (all p's <.02) were found for all global and domain scores. The largest interaction effects were observed for complex domains of Financial Conceptual Knowledge, Checkbook Management, Bank Statement Management, and Bill Payment (all p's <.0001). Annualized decline in the MCI group's global scores, calculated in relation to CN group performance, was 10-17% over the initial 3-year time span and 22-24% at 6 years. Decline in FCI domain scores ranged from 6% (Knowledge of Assets/Estate) to 22% (Investment Decision-Making) at 3 year follow-up, and from 15% (Basic Monetary Skills) to 37% (Financial Judgment) at 6 year follow-up.
Over a 6-year period, persons with MCI demonstrated significant declines in multiple financial skills and in particular financial judgment. The findings highlight the importance of ongoing oversight by family members and clinicians of financial skills and activities in persons with MCI.
研究疑似因阿尔茨海默病（AD）导致轻度认知障碍（MCI）的患者在6年期间的财务技能衰退情况。
根据共识会议诊断，研究参与者为认知正常（CN）的老年人（n = 82）和患有MCI的成年人（n = 91）。参与者完成了基线评估以及多达六次年度随访评估，其中包括标准化财务技能测量（财务能力工具；FCI；九个FCI领域和两个总体得分）。我们使用针对基线年龄和随访时长进行调整的混合模型重复测量分析来研究FCI随时间的变化。
在基线时，CN组在总体得分和七个领域得分方面均优于MCI组。在所有总体得分和领域得分中均发现了组×时间交互效应（所有p值<.02）。在财务概念知识、支票簿管理、银行对账单管理和账单支付等复杂领域观察到最大的交互效应（所有p值<.0001）。与CN组表现相关计算得出，MCI组在最初3年时间跨度内总体得分的年化衰退率为10 - 17%，6年时为22 - 24%。在3年随访时，FCI领域得分的衰退率从6%（资产/遗产知识）到22%（投资决策）不等，在6年随访时从15%（基本货币技能）到37%（财务判断）不等。
在6年期间，MCI患者在多种财务技能尤其是财务判断方面出现了显著衰退。这些发现凸显了家庭成员和临床医生对MCI患者财务技能和活动进行持续监督的重要性。
