Journal
PARKINSONISM & RELATED DISORDERS
Volume 19, Issue 11, Pages 986-990Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.parkreldis.2013.06.017
Keywords
Financial ability; Functional change; MCI (mild cognitive impairment); Parkinson's disease with dementia; Parkinson's disease/parkinsonism
Categories
Funding
- Alzheimer's Disease Research Center [1P50 AG16582]
- National Institution on Aging [5 R01 AG021927]
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Purpose: Financial capacity (FC) is an instrumental activity of daily living (IADL) critical to independent functioning and sensitive to cognitive impairment in dementia. Little is known about FC in cognitively impaired patients with Parkinson's disease (PD). The present study investigated FC in PD patients with prodromal and clinical dementia. Methods: Participants were 20 older controls and 35 PD patients who met consensus criteria for either mild cognitive impairment (PD-MCI, n = 18) or PD dementia (PDD, n = 17). FC was assessed using a standardized performance based measure consisting of 9 domain and two global scores (Financial Capacity Instrument; FCI) (1). FCI domain and global performance scores were compared across groups. Capacity impairment ratings (no impairment, mild/moderate impairment, severe impairment) were calculated for each PD patient's domain and global scores. Results: Relative to controls, PD-MCI patients were impaired on both FCI global scores and domains of basic monetary skills, financial concepts, and investment decision-making. Relative to both controls and PD-MCI patients, PDD patients were impaired on virtually all FCI variables. With respect to impairment ratings, greater than 50% of PD-MCI patients and greater than 90% of PDD patients were classified as either mild/moderate or severely impaired on the two FCI global scores. Conclusions: Impairment of financial capacity is already present in PD-MCI and is advanced in PDD. Complex cognitively-mediated IADLs such as financial capacity appear to be impaired early in the course of PD dementia. (C) 2013 Elsevier Ltd. All rights reserved.
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