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. 2019 Jul;266(7):1698-1707.
doi: 10.1007/s00415-019-09317-w. Epub 2019 Apr 22.

Financial capacity in frontotemporal dementia and related presentations

Sascha Gill  1 , Mervin Blair  1 , Mavis Kershaw  2   3   4 , Sarah Jesso  1 , Julia MacKinley  1 , Kristy Coleman  1 , Koula Pantazopoulos  1 , Stephen Pasternak  1 , Elizabeth Finger  5
Affiliations

Financial capacity in frontotemporal dementia and related presentations

Sascha Gill et al. J Neurol. 2019 Jul.

Abstract

Background: Changes in financial judgement and skills can herald a neurodegenerative dementia and are a common reason for referral for cognitive neurologic assessment. However, patients with neurodegenerative diseases affecting the frontal or temporal lobes may perform well on standard cognitive tests, complicating clinical determinations about their diagnosis and financial capacity.

Methods: Forty-five patients with possible or probable FTD or Alzheimer's disease and 22 healthy controls completed two financial assessment batteries, the FACT and the FCAI. Patients' performance was compared to study partner estimates of patients' financial abilities.

Results: All three patient groups performed worse than controls on both the FACT and the FCAI. Study partners over-estimated the performance of patients with Alzheimer's disease.

Conclusions: These initial findings suggest that accurate clinical assessment of financial skills and judgement in patients with possible neurodegenerative dementias requires performance-based assessment.

Keywords: FTD phenocopy; Financial capacity; Frontotemporal dementia.

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Conflict of interest statement

M Kershaw was involved in the development of one of the financial assessment tools used in the study (FCAI) and serves as an occasional unpaid consultant to Matek Pty Ltd regarding the FCAI. The other authors have no conflicts of interest related to this study.

Figures

Fig. 1
Fig. 1
Comparison of mean FACT raw scores across groups. Asterisk: significant findings using one-way ANOVAs with Bonferroni-corrected post hoc contrasts. Memory: controls and pheno/poss-bvFTD scored higher than AD; controls scored higher than bvFTD. Calculation/Attention: controls scored higher than pheno/poss-bvFTD. Daily Financial Tasks: controls scored higher than bvFTD. General Financial Knowledge: controls scored higher than pheno/poss-bvFTD and bvFTD. Understanding Assets: controls scored higher than bvFTD. Financial Insight: controls and AD scored higher than bvFTD; controls scored higher than pheno/poss-bvFTD. Financial Confidence: controls scored higher than bvFTD; AD scored higher than pheno/poss-bvFTD and bvFTD. FACT total score (not shown): controls scored higher than pheno/poss-bvFTD and bvFTD; AD scored higher than bvFTD
Fig. 2
Fig. 2
Comparison of mean FCAI standard score across groups. Asterisk: significant findings using one-way ANOVAs with Bonferroni-corrected post hoc contrasts: Everyday Financial Abilities: controls scored higher than pheno/poss-bvFTD, bvFTD and AD. Financial Judgement: controls scored higher than AD and bvFTD; pheno/poss-bvFTD scored higher than bvFTD. Estate Management: controls scored higher than pheno/poss-bvFTD, AD and bvFTD; pheno/poss-bvFTD scored higher than bvFTD. Cognitive Functioning: controls scored higher than bvFTD and AD. Support Resources: controls scored higher than pheno/poss-bvFTD, AD and bvFTD. Understanding: controls and pheno/poss-bvFTD scored higher than AD and bvFTD. Appreciation: controls scored higher than AD, pheno/poss-bvFTD and FTD; AD scored higher than bvFTD. Reasoning: controls scored higher than AD and bvFTD. Expressing a Choice: controls scored higher than AD, pheno/poss-bvFTD and bvFTD. FCAI total score (not shown): controls scored higher than pheno/poss-bvFTD, AD and bvFTD
Fig. 3
Fig. 3
Financial Competence Assessment Inventory (FCAI-6) patient performance and caregiver report for the six domains. All results indicated are based on mixed-factorial ANOVAs, ps < 0.05. Asterisk: significant interactions
Fig. 4
Fig. 4
Financial Competence Assessment Inventory (FCAI-4) patient performance and caregiver report for the four domains. All results indicated are based on mixed-factorial ANOVAs, ps < 0.05. Asterisk: significant interactions
See this image and copyright information in PMC

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