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Posted: February 19, 2008

Even Mild Alzheimer's Sparks Startling Decline in Financial Skill

Patients contending with even the mildest forms of Alzheimer’s disease show a dramatic decline in their ability to make financial decisions, adding to the burden of caregivers when it comes to elderly estate planning and fraud prevention, according to newly published research.
Research conducted by a team from the University of Alabama at Birmingham and published online in the American Journal of Geriatric Psychiatry compared 55 patients with mild Alzheimer’s against 63 healthy older adults and followed them for one year. At the beginning of the trial, the mild AD group already showed a 20% decline in overall financial ability compared to the control group. However, by the end of the year, the AD group had dropped 10% more – a 50% increase in the decline of skills.
“After just one year, the mild AD group had dropped to 70% of the financial capacity demonstrated by the healthy older adult group, a significant decline,” said Daniel Marson, J.D., Ph.D., director of the UAB Alzheimer’s Disease Center and the study’s lead author.
Patients were assessed on a variety of financial skills, including basic monetary skills, checkbook management, bill payment and understanding a bank statement. Tasks varied from simple ones such as identifying specific coins and currency to complex ones such as preparing bills, checks and envelopes for mailing.
Assessments were done using the Financial Capacity Instrument, (FCI-9), an instrument developed by Marson’s group. The FCI-9 measures 18 different financial tasks within nine domains and has two overall scores.
The Alzheimer’s group showed substantial declines in overall financial capacity -- on eight of the nine financial domains and on 12 of the 18 financial tasks. Of particular concern was decline in the ability to recognize telephone or mail fraud.
“Elder fraud is a serious problem and our findings suggest that even patients with mild Alzheimer’s are at significantly increased risk for becoming victims of fraud,” said Marson.
Overall, the study found that impairment in financial skills occurs early in Alzheimer’s disease, progresses relatively rapidly over time, and includes declines in basic judgment and monetary calculation skills. The findings underscore the importance, at the time of diagnosis, of patients with mild AD and their families promptly pursuing financial planning and transfer of financial responsibilities, Marson said.
The research team noted that caregiving families can be proactive at the earliest sign of Alzheimer’s by finalizing trust and estate arrangements, delegating financial decision-making powers, planning for eventual financial incapacity, and providing increased supervision of existing financial activities.
This research was supported by grants from the National Institute on Aging and the National Institute of Mental Health.

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