Department of Neurology, University of Alabama at Birmingham, Birmingham, AL.
Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, AL.
Int J Geriatr Psychiatry. 2019 Aug;34(8):1200-1207. doi: 10.1002/gps.5118. Epub 2019 May 3.
Although financial ability has been well-studied in mild cognitive impairment (MCI) and Alzheimer's disease (AD) using performance-based financial capacity assessment instruments, research is limited investigating everyday financial problems and declines in persons with AD and MCI and the insight of people with MCI to recognize that financial capacity declines are occurring. To address this gap in the research, we investigated everyday financial activities and skills in a sample of older adults representing the dementia spectrum.
Participants were 186 older adults in three diagnostic classifications: cognitively healthy, MCI likely due to AD, and mild AD dementia. Everyday financial ability was assessed using the Current Financial Activities Report (CFAR). The CFAR is a standardized report-based measure which elicits participant and study partner ratings about a participant's everyday financial abilities.
Results showed that both CFAR self- and study partner-report distinguished diagnostic groups on key financial capacity variables in a pattern consistent with level of clinical pathology. Study partner-report indicated higher levels of financial skill difficulties in study participants than did the self-report of the same study participants. Study partner-ratings were more highly correlated with participant scores on a performance-based measure of financial capacity than were participant self-ratings. Results also showed that loss of awareness of financial decline is emerging at the MCI stage of AD.
People with MCI represent a group of older adults at particular risk for financial missteps and-similar to people with AD-are in need of supervision of their financial skills and activities.
虽然使用基于表现的财务能力评估工具已经对轻度认知障碍 (MCI) 和阿尔茨海默病 (AD) 中的财务能力进行了充分研究，但研究人员对 AD 和 MCI 患者日常财务问题和财务能力下降的研究有限，以及对 MCI 患者识别财务能力下降的洞察力有限。为了弥补研究中的这一空白，我们调查了代表痴呆症谱系的老年人样本中的日常财务活动和技能。
参与者为 186 名年龄较大的成年人，分为三个诊断分类：认知健康、可能因 AD 导致的 MCI 和轻度 AD 痴呆。使用当前财务活动报告 (CFAR) 评估日常财务能力。CFAR 是一种基于标准化报告的衡量标准，它会引发参与者和研究伙伴对参与者日常财务能力的评估。
结果表明，CFAR 自我报告和研究伙伴报告都能根据临床病理水平区分诊断组在关键财务能力变量上的差异。研究伙伴报告的研究参与者的财务技能困难程度高于同一研究参与者的自我报告。研究伙伴的评分与参与者在基于表现的财务能力衡量标准上的得分比参与者的自我评分相关性更高。结果还表明，在 AD 的 MCI 阶段，对财务下降的认识丧失正在出现。
MCI 患者代表了一群面临财务失误特别风险的老年人，与 AD 患者相似，他们需要监督自己的财务技能和活动。
