Burgio Francesca, Benavides-Varela Silvia, Toffano Roberta, Palmer Katie, Meneghello Francesca, Arcara Giorgio, Semenza Carlo
IRCCS San Camillo Hospital, Venice, Italy.
Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy.
Neurol Sci. 2022 Jan;43(1):299-303. doi: 10.1007/s10072-021-05304-0. Epub 2021 May 20.
Patients with mild cognitive impairment (MCI) might experience difficulties in numerical and financial abilities of daily living that compromise their autonomy. The aim of the present work was to examine whether specific tests of the standard neuropsychological assessment could be used to predict these deficits in the clinical practice. Thirty-four MCI patients underwent a comprehensive clinical and neuropsychological examination including (1) a complete assessment of financial abilities and (2) a traditional neuropsychological assessment including measures of language, memory, executive functioning, reasoning, attention, and visuospatial abilities. The neuropsychological tests were used as predictors of the performance in everyday financial tasks using logistic regression analysis. Deficits in financial tasks including calculating percentages, using financial concepts and applying financial judgments were significantly predicted by tests of executive functions, language and short-term memory, while deficits in frequently encountered financial tasks activities such as item purchase and reading numbers could not be predicted by standard neuropsychological evaluations. Contingency tables on performance above/below clinical cut-offs evidenced some cases of financial deficits in the absence of cognitive deficits and, vice versa, some patients with cognitive decline did not show financial impairments. These results suggest that while some cognitive functions might be crucial for taking financial decisions, an ad hoc test of financial capacity is essential to make overall inferences about the everyday financial autonomy of MCI patients. This has potential implications for clinical and legal decisions that directly impact the individuals and their families.
轻度认知障碍（MCI）患者在日常生活中的数字和财务能力方面可能会遇到困难，这会损害他们的自主性。本研究的目的是检验标准神经心理学评估中的特定测试是否可用于在临床实践中预测这些缺陷。34名MCI患者接受了全面的临床和神经心理学检查，包括（1）对财务能力的完整评估，以及（2）传统的神经心理学评估，包括语言、记忆、执行功能、推理、注意力和视觉空间能力的测量。使用逻辑回归分析，将神经心理学测试用作日常财务任务表现的预测指标。执行功能、语言和短期记忆测试可显著预测包括计算百分比、运用财务概念和应用财务判断在内的财务任务中的缺陷，而诸如商品购买和读取数字等常见财务任务活动中的缺陷则无法通过标准神经心理学评估进行预测。高于/低于临床临界值表现的列联表表明，在没有认知缺陷的情况下存在一些财务缺陷案例，反之，一些认知能力下降的患者并未表现出财务障碍。这些结果表明，虽然某些认知功能对于做出财务决策可能至关重要，但专门的财务能力测试对于全面推断MCI患者的日常财务自主性至关重要。这对直接影响个人及其家庭的临床和法律决策具有潜在影响。
