Nowrangi Milap A, Leoutsakos Jeannie Marie, Yan Haijuan, Bakker Arnold, Manning Kevin J, Rebok George W, Rosenberg Paul B, Kamath Vidyulata
Department of Psychiatry and Behavioral Sciences The Johns Hopkins University School of Medicine Baltimore Maryland USA.
Department of Neurology The Johns Hopkins University School of Medicine Baltimore Maryland USA.
Alzheimers Dement (Amst). 2025 Mar 20;17(1):e12583. doi: 10.1002/dad2.12583. eCollection 2025 Jan-Mar.
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).
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.
A total of 874 participants (diagnostic group, , 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 ( = 1.35 (0.55), = 0.016) and total completion time of the FCI-SF ( = 1.85 (9.36), = 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] = 008).
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.
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.
财务能力（FC）是指以符合自身利益的方式独立管理财务的能力。为了研究财务能力、认知领域、神经精神症状以及从正常认知（认知正常[CN]）向轻度认知障碍（MCI）或阿尔茨海默病（AD）转变之间的关系，我们使用财务能力工具简表（FCI-SF）对阿尔茨海默病神经影像倡议（ADNI）队列进行了二次分析。
为了检验这些纵向关系，我们拟合了两个模型，一个随机效应（随机截距）“时间平均”模型和一个“上次就诊以来的时间”模型，在这两个模型中，我们将五个财务分项得分中的每一个对每个认知综合得分进行回归分析。为了检验基线FCI-SF表现对从正常向MCI或AD转化率的影响，我们计算了一个生存模型。
共有874名参与者（诊断组，平均年龄：CN组501人，74.4岁；MCI组319人，74.6岁；AD组54人，74.9岁）纳入分析。在“上次就诊以来的时间”模型中，我们发现较低的执行功能综合得分与复杂支票簿得分下降（β = 1.35[0.55]，P = 0.016）以及FCI-SF的总完成时间下降（β = 1.85[9.36]，P = 0.025）相关。此外，较低的视觉空间综合得分与财务概念知识、复杂支票簿及总完成时间方面的较差表现显著相关。较低的记忆综合得分与财务概念知识、单张支票簿及银行对账单子量表得分下降高度相关。在任何时间点，ADNI参与者中总完成时间处于最低三分位数的人被诊断为MCI或AD的可能性是处于最高三分位数参与者的四倍，风险比为4.22（[2.29]P = 0.008）。
较差的认知与日常财务功能之间存在多方面的相互作用，其中执行功能、记忆和视觉空间认知与财务能力相关。从正常向MCI或AD转变的最强预测因素似乎是完成时间。
在向痴呆转变过程中观察到财务能力（FC）下降，且增加了不良后果的风险。执行功能、记忆和视觉空间认知与财务能力相关。从正常向轻度认知障碍（MCI）或阿尔茨海默病（AD）转变的最强预测因素是完成时间或处理速度。
