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Daniel C Marson - One of the best experts on this subject based on the ideXlab platform.

  • declining Financial Capacity in mild cognitive impairment a six year longitudinal study
    Archives of Clinical Neuropsychology, 2019
    Co-Authors: Roy C. Martin, Kristen L. Triebel, Adam Gerstenecker, Michael Falola, Tarrant Mcpherson, Gary Cutter, Daniel C Marson
    Abstract:

    Objective To investigate Financial skill decline over a 6-year period in persons with mild cognitive impairment (MCI) presumed due to Alzheimer's disease (AD). Methods Study participants were cognitively normal (CN) older adults (n = 82) and adults with MCI (n = 91) based on consensus conference diagnosis. Participants completed baseline and up to six annual follow-up assessments that included standardized Financial skills measurement (Financial Capacity Instrument; FCI; nine FCI domain and two global scores). We examined FCI change over time using mixed-model repeated measures analysis adjusted for baseline age and follow-up duration. Results At baseline, the CN group performed better than the MCI group across both global and seven domain scores. Group × Time interaction effects (all p's <.02) were found for all global and domain scores. The largest interaction effects were observed for complex domains of Financial Conceptual Knowledge, Checkbook Management, Bank Statement Management, and Bill Payment (all p's <.0001). Annualized decline in the MCI group's global scores, calculated in relation to CN group performance, was 10-17% over the initial 3-year time span and 22-24% at 6 years. Decline in FCI domain scores ranged from 6% (Knowledge of Assets/Estate) to 22% (Investment Decision-Making) at 3 year follow-up, and from 15% (Basic Monetary Skills) to 37% (Financial Judgment) at 6 year follow-up. Conclusions Over a 6-year period, persons with MCI demonstrated significant declines in multiple Financial skills and in particular Financial judgment. The findings highlight the importance of ongoing oversight by family members and clinicians of Financial skills and activities in persons with MCI.

  • age and education corrected older adult normative data for a short form version of the Financial Capacity instrument
    Psychological Assessment, 2016
    Co-Authors: Adam Gerstenecker, Kristen L. Triebel, Roy C. Martin, Amanda Eakin, Dana Swensondravis, Ronald C Petersen, Daniel C Marson
    Abstract:

    Financial Capacity is an instrumental activity of daily living (IADL) that comprises multiple abilities and is critical to independence and autonomy in older adults. Due to its cognitive complexity, Financial Capacity is often the first IADL to show decline in prodromal and clinical Alzheimer’s disease and related disorders. Despite its importance, few standardized assessment measures of Financial Capacity exist and there is little, if any, normative data available to evaluate Financial skills in the elderly. The Financial Capacity Instrument – Short Form (FCI-SF) is a brief measure of Financial skills designed to evaluate Financial skills in older adults with cognitive impairment. In the current study, we present age- and education-adjusted normative data for FCI-SF variables in a sample of 1344 cognitively normal, community-dwelling older adults participating in the Mayo Clinic Study of Aging (MCSA) in Olmsted County, Minnesota. Individual FCI-SF raw scores were first converted to age-corrected scaled scores based on position within a cumulative frequency distribution and then grouped within four empirically supported and overlapping age ranges. These age-corrected scaled scores were then converted to age- and education-corrected scaled scores using the same methodology. This study has the potential to substantially enhance Financial Capacity evaluations of older adults through the introduction of age- and education-corrected normative data for the FCI-SF by allowing clinicians to: 1) compare an individual’s performance to that of a sample of similar age and education peers, 2) interpret various aspects of Financial Capacity relative to a normative sample, and 3) make comparisons between these aspects.

  • age and education corrected older adult normative data for a short form version of the Financial Capacity instrument
    Psychological Assessment, 2016
    Co-Authors: Adam Gerstenecker, Kristen L. Triebel, Roy C. Martin, Amanda Eakin, Dana Swensondravis, Ronald C Petersen, Daniel C Marson
    Abstract:

    Financial Capacity is an instrumental activity of daily living (IADL) that comprises multiple abilities and is critical to independence and autonomy in older adults. Because of its cognitive complexity, Financial Capacity is often the first IADL to show decline in prodromal and clinical Alzheimer's disease and related disorders. Despite its importance, few standardized assessment measures of Financial Capacity exist and there is little, if any, normative data available to evaluate Financial skills in the elderly. The Financial Capacity Instrument-Short Form (FCI-SF) is a brief measure of Financial skills designed to evaluate Financial skills in older adults with cognitive impairment. In the current study, we present age- and education-adjusted normative data for FCI-SF variables in a sample of 1344 cognitively normal, community-dwelling older adults participating in the Mayo Clinic Study of Aging (MCSA) in Olmsted County, Minnesota. Individual FCI-SF raw scores were first converted to age-corrected scaled scores based on position within a cumulative frequency distribution and then grouped within 4 empirically supported and overlapping age ranges. These age-corrected scaled scores were then converted to age- and education-corrected scaled scores using the same methodology. This study has the potential to substantially enhance Financial Capacity evaluations of older adults through the introduction of age- and education-corrected normative data for the FCI-SF by allowing clinicians to: (a) compare an individual's performance to that of a sample of similar age and education peers, (b) interpret various aspects of Financial Capacity relative to a normative sample, and (c) make comparisons between these aspects. (PsycINFO Database Record

  • declining Financial Capacity in mild cognitive impairment a 1 year longitudinal study
    Neurology, 2009
    Co-Authors: Kristen L. Triebel, Ozioma C. Okonkwo, Roy C. Martin, Lindy E. Harrell, Alfred A Bartolucci, David G Clark, John C Brockington, H R Griffith, Janice C Marceaux, Daniel C Marson
    Abstract:

    Objective: To investigate 1-year change in Financial Capacity in relation to conversion from amnestic mild cognitive impairment (MCI) to dementia. Methods: Seventy-six cognitively healthy older controls, 25 patients with amnestic MCI who converted to Alzheimer-type dementia during the study period (MCI converters), and 62 patients with MCI who did not convert to dementia (MCI nonconverters) were administered the Financial Capacity Instrument (FCI) at baseline and 1-year follow-up. Performance on the FCI domain and global scores was compared within and between groups using multivariate repeated-measures analyses. Results: At baseline, controls performed better than MCI converters and nonconverters on almost all FCI domains and on both FCI total scores. MCI converters performed below nonconverters on domains of Financial concepts, cash transactions, bank statement management, and bill payment and on both FCI total scores. At 1-year follow-up, MCI converters showed significantly greater decline than controls and MCI nonconverters for the domain of checkbook management and for both FCI total scores. The domain of bank statement management showed a strong trend. For both the checkbook and bank statement domains, MCI converters showed declines in procedural skills, such as calculating the correct balance in a checkbook register, but not in conceptual understanding of a checkbook or a bank statement. Conclusions: Declining Financial skills are detectable in patients with mild cognitive impairment (MCI) in the year before their conversion to Alzheimer disease. Clinicians should proactively monitor patients with MCI for declining Financial skills and advise patients and families about appropriate interventions.

  • clinical interview assessment of Financial Capacity in older adults with mild cognitive impairment and alzheimer s disease
    Journal of the American Geriatrics Society, 2009
    Co-Authors: Daniel C Marson, Roy C. Martin, Randall H Griffith, Scott Snyder, Virginia G Wadley, Patricia S Goode, Cleveland F Kinney, Anthony P Nicholas, Terri Steele, Britt Anderson
    Abstract:

    OBJECTIVES: To investigate Financial Capacity in patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) using a clinician interview approach. DESIGN: Cross-sectional. SETTING: Tertiary care medical center. PARTICIPANTS: Healthy older adults (n 575) and patients with amnestic MCI (n 558), mild AD (n 597), and moderate AD (n 531). MEASUREMENTS: The investigators and five study physicians developed a conceptually based, semistructured clinical interview for evaluating seven core Financial domains and overall Financial Capacity (Semi-Structured Clinical Interview for Financial Capacity; SCIFC). For each participant, a physician made Capacity judgments (capable, marginally capable, or incapable) for each Financial domain and for overall Capacity. RESULTS: Study physicians made more than 11,000 Capacity judgments across the study sample (N 5261). Very good interrater agreement was obtained for the SCIFC judgments. Increasing proportions of marginal and incapable judgment ratings were associated with increasing disease severity across the four study groups. For overall Financial Capacity, 95% of physician judgments for older controls were rated as capable, compared with 82% for patients with MCI, 26% for patients with mild AD, and 4% for patients with moderate AD. CONCLUSION: Physicians and other clinicians can reliably evaluate Financial Capacity in cognitively impaired older adults using a relatively brief, semistructured clinical interview. Patients with MCI have mild impairment in Financial Capacity, those with mild AD have emerging global impairment, and those with moderate AD have advanced global impairment. Patients with MCI and their families should proactively engage in Financial and legal planning, given these patients’ risk of developing AD and accelerated loss of Financial abilities. J Am Geriatr Soc 57:806–814, 2009.

Lindy E. Harrell - One of the best experts on this subject based on the ideXlab platform.

  • mri volume of the medial frontal cortex predicts Financial Capacity in patients with mild alzheimer s disease
    Brain Imaging and Behavior, 2013
    Co-Authors: Luke E. Stoeckel, Christopher C. Stewart, Kristen L. Triebel, Ozioma C. Okonkwo, Roy C. Martin, Katherine Belue, Jacquelynn N. Copeland, Randall H Griffith, Jan Den A Hollander, Lindy E. Harrell
    Abstract:

    Persons with mild Alzheimer’s disease (AD) have significant deficits in Financial abilities. This study examined the relationship between brain structure volumes, cognition, and Financial Capacity in patients with mild AD. Sixteen mild AD patients and 16 older adult comparisons completed the Financial Capacity Instrument (FCI), a psychometric measure of Financial abilities, and also underwent magnetic resonance imaging (MRI) to obtain volumes of the bilateral hippocampi, angular gyri, precunei, and medial and dorsolateral frontal cortices. Mild AD patients performed significantly below comparisons on the FCI and had significantly smaller hippocampi. Among mild AD patients, FCI performance was moderately correlated with frontal (medial and dorsolateral frontal cortex) and posterior (angular gyri and precunei) cortical volumes. Stepwise regression demonstrated that medial frontal cortex volume predicted FCI score. The relationship between medial frontal cortex volume and overall FCI score was partially mediated by two measures of simple attention (DRS Attention, DRS Construction). The findings suggest that medial frontal cortex atrophy and associated declines in simple attention play an increasingly important role in declining Financial skills in patients with mild AD.

  • magnetic resonance imaging volume of the angular gyri predicts Financial skill deficits in people with amnestic mild cognitive impairment
    Journal of the American Geriatrics Society, 2010
    Co-Authors: Randall H Griffith, Christopher C. Stewart, Ozioma C. Okonkwo, Roy C. Martin, Katherine Belue, Jacquelynn N. Copeland, Jan Den A Hollander, Lindy E. Harrell, Luke E. Stoeckel, John C Brockington
    Abstract:

    OBJECTIVES: To better understand how brain atrophy in amnestic mild cognitive impairment (MCI) as measured using magnetic resonance imaging (MRI) volumetrics could affect instrumental activities of daily living (IADLs) such as Financial abilities. DESIGN: Controlled, matched-sample, cross-sectional analysis regressing MRI volumetrics with Financial performance measures. SETTING: University medical and research center. PARTICIPANTS: Thirty-eight people with MCI and 28 older adult controls. MEASUREMENTS: MRI volumetric measurement of the hippocampi, angular gyri, precunei, and medial frontal lobes. Participants also completed neuropsychological tests and the Financial Capacity Instrument (FCI). RESULTS: Correlations were performed between FCI scores and MRI volumes in the group with MCI. People with MCI performed significantly below controls on the FCI and had significantly smaller hippocampi. Among people with MCI, performance on the FCI was moderately correlated with angular gyri and precunei volumes. Regression models demonstrated that angular gyrus volumes were predictive of FCI scores. Tests of mediation showed that measures of arithmetic and possibly attention partially mediated the relationship between angular gyrus volume and FCI score. CONCLUSION: Impaired Financial abilities in amnestic MCI correspond with volume of the angular gyri as mediated by arithmetic knowledge. The findings suggest that early neuropathology within the lateral parietal region in MCI leads to a breakdown of cognitive abilities that affect everyday Financial skills. The findings have implications for diagnosis and clinical care of people with MCI and AD.

  • declining Financial Capacity in mild cognitive impairment a 1 year longitudinal study
    Neurology, 2009
    Co-Authors: Kristen L. Triebel, Ozioma C. Okonkwo, Roy C. Martin, Lindy E. Harrell, Alfred A Bartolucci, David G Clark, John C Brockington, H R Griffith, Janice C Marceaux, Daniel C Marson
    Abstract:

    Objective: To investigate 1-year change in Financial Capacity in relation to conversion from amnestic mild cognitive impairment (MCI) to dementia. Methods: Seventy-six cognitively healthy older controls, 25 patients with amnestic MCI who converted to Alzheimer-type dementia during the study period (MCI converters), and 62 patients with MCI who did not convert to dementia (MCI nonconverters) were administered the Financial Capacity Instrument (FCI) at baseline and 1-year follow-up. Performance on the FCI domain and global scores was compared within and between groups using multivariate repeated-measures analyses. Results: At baseline, controls performed better than MCI converters and nonconverters on almost all FCI domains and on both FCI total scores. MCI converters performed below nonconverters on domains of Financial concepts, cash transactions, bank statement management, and bill payment and on both FCI total scores. At 1-year follow-up, MCI converters showed significantly greater decline than controls and MCI nonconverters for the domain of checkbook management and for both FCI total scores. The domain of bank statement management showed a strong trend. For both the checkbook and bank statement domains, MCI converters showed declines in procedural skills, such as calculating the correct balance in a checkbook register, but not in conceptual understanding of a checkbook or a bank statement. Conclusions: Declining Financial skills are detectable in patients with mild cognitive impairment (MCI) in the year before their conversion to Alzheimer disease. Clinicians should proactively monitor patients with MCI for declining Financial skills and advise patients and families about appropriate interventions.

  • neurocognitive predictors of Financial Capacity across the dementia spectrum normal aging mild cognitive impairment and alzheimer s disease
    Journal of The International Neuropsychological Society, 2009
    Co-Authors: Megan G Sherod, Katherine Belue, Jacquelynn N. Copeland, Randall H Griffith, Lindy E. Harrell, Edward Zamrini, Sara Krzywanski, David G Clark, John C Brockington, Richard E Powers
    Abstract:

    Financial Capacity is a complex instrumental activity of daily living critical to independent functioning of older adults and sensitive to impairment in patients with amnestic mild cognitive impairment (MCI) and Alzheimer’s disease (AD). However, little is known about the neurocognitive basis of Financial impairment in dementia. We developed cognitive models of Financial Capacity in cognitively healthy older adults (n = 85) and patients with MCI (n = 113) and mild AD (n = 43). All participants were administered the Financial Capacity Instrument (FCI) and a neuropsychological test battery. Univariate correlation and multiple regression procedures were used to develop cognitive models of overall FCI performance across groups. The control model (R2 = .38) comprised (in order of entry) written arithmetic skills, delayed story recall, and simple visuomotor sequencing. The MCI model (R2 = .69) comprised written arithmetic skills, visuomotor sequencing and set alternation, and race. The AD model (R2 = .65) comprised written arithmetic skills, simple visuomotor sequencing, and immediate story recall. Written arithmetic skills (WRAT-3 Arithmetic) was the primary predictor across models, accounting for 27% (control model), 46% (AD model), and 55% (MCI model) of variance. Executive function and verbal memory were secondary model predictors. The results offer insight into the cognitive basis of Financial Capacity across the dementia spectrum of cognitive aging, MCI, and AD.

  • neurocognitive predictors of Financial Capacity across the dementia spectrum normal aging mild cognitive impairment and alzheimer s disease
    Journal of The International Neuropsychological Society, 2009
    Co-Authors: Megan G Sherod, Katherine Belue, Jacquelynn N. Copeland, Randall H Griffith, Lindy E. Harrell, Edward Zamrini, Sara Krzywanski, David G Clark, John C Brockington, Richard E Powers
    Abstract:

    Financial Capacity is a complex instrumental activity of daily living critical to independent functioning of older adults and sensitive to impairment in patients with amnestic mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, little is known about the neurocognitive basis of Financial impairment in dementia. We developed cognitive models of Financial Capacity in cognitively healthy older adults (n = 85) and patients with MCI (n = 113) and mild AD (n = 43). All participants were administered the Financial Capacity Instrument (FCI) and a neuropsychological test battery. Univariate correlation and multiple regression procedures were used to develop cognitive models of overall FCI performance across groups. The control model (R2 = .38) comprised (in order of entry) written arithmetic skills, delayed story recall, and simple visuomotor sequencing. The MCI model (R2 = .69) comprised written arithmetic skills, visuomotor sequencing and set alternation, and race. The AD model (R2 = .65) comprised written arithmetic skills, simple visuomotor sequencing, and immediate story recall. Written arithmetic skills (WRAT-3 Arithmetic) was the primary predictor across models, accounting for 27% (control model), 46% (AD model), and 55% (MCI model) of variance. Executive function and verbal memory were secondary model predictors. The results offer insight into the cognitive basis of Financial Capacity across the dementia spectrum of cognitive aging, MCI, and AD.

Roy C. Martin - One of the best experts on this subject based on the ideXlab platform.

  • declining Financial Capacity in mild cognitive impairment a six year longitudinal study
    Archives of Clinical Neuropsychology, 2019
    Co-Authors: Roy C. Martin, Kristen L. Triebel, Adam Gerstenecker, Michael Falola, Tarrant Mcpherson, Gary Cutter, Daniel C Marson
    Abstract:

    Objective To investigate Financial skill decline over a 6-year period in persons with mild cognitive impairment (MCI) presumed due to Alzheimer's disease (AD). Methods Study participants were cognitively normal (CN) older adults (n = 82) and adults with MCI (n = 91) based on consensus conference diagnosis. Participants completed baseline and up to six annual follow-up assessments that included standardized Financial skills measurement (Financial Capacity Instrument; FCI; nine FCI domain and two global scores). We examined FCI change over time using mixed-model repeated measures analysis adjusted for baseline age and follow-up duration. Results At baseline, the CN group performed better than the MCI group across both global and seven domain scores. Group × Time interaction effects (all p's <.02) were found for all global and domain scores. The largest interaction effects were observed for complex domains of Financial Conceptual Knowledge, Checkbook Management, Bank Statement Management, and Bill Payment (all p's <.0001). Annualized decline in the MCI group's global scores, calculated in relation to CN group performance, was 10-17% over the initial 3-year time span and 22-24% at 6 years. Decline in FCI domain scores ranged from 6% (Knowledge of Assets/Estate) to 22% (Investment Decision-Making) at 3 year follow-up, and from 15% (Basic Monetary Skills) to 37% (Financial Judgment) at 6 year follow-up. Conclusions Over a 6-year period, persons with MCI demonstrated significant declines in multiple Financial skills and in particular Financial judgment. The findings highlight the importance of ongoing oversight by family members and clinicians of Financial skills and activities in persons with MCI.

  • age and education corrected older adult normative data for a short form version of the Financial Capacity instrument
    Psychological Assessment, 2016
    Co-Authors: Adam Gerstenecker, Kristen L. Triebel, Roy C. Martin, Amanda Eakin, Dana Swensondravis, Ronald C Petersen, Daniel C Marson
    Abstract:

    Financial Capacity is an instrumental activity of daily living (IADL) that comprises multiple abilities and is critical to independence and autonomy in older adults. Due to its cognitive complexity, Financial Capacity is often the first IADL to show decline in prodromal and clinical Alzheimer’s disease and related disorders. Despite its importance, few standardized assessment measures of Financial Capacity exist and there is little, if any, normative data available to evaluate Financial skills in the elderly. The Financial Capacity Instrument – Short Form (FCI-SF) is a brief measure of Financial skills designed to evaluate Financial skills in older adults with cognitive impairment. In the current study, we present age- and education-adjusted normative data for FCI-SF variables in a sample of 1344 cognitively normal, community-dwelling older adults participating in the Mayo Clinic Study of Aging (MCSA) in Olmsted County, Minnesota. Individual FCI-SF raw scores were first converted to age-corrected scaled scores based on position within a cumulative frequency distribution and then grouped within four empirically supported and overlapping age ranges. These age-corrected scaled scores were then converted to age- and education-corrected scaled scores using the same methodology. This study has the potential to substantially enhance Financial Capacity evaluations of older adults through the introduction of age- and education-corrected normative data for the FCI-SF by allowing clinicians to: 1) compare an individual’s performance to that of a sample of similar age and education peers, 2) interpret various aspects of Financial Capacity relative to a normative sample, and 3) make comparisons between these aspects.

  • age and education corrected older adult normative data for a short form version of the Financial Capacity instrument
    Psychological Assessment, 2016
    Co-Authors: Adam Gerstenecker, Kristen L. Triebel, Roy C. Martin, Amanda Eakin, Dana Swensondravis, Ronald C Petersen, Daniel C Marson
    Abstract:

    Financial Capacity is an instrumental activity of daily living (IADL) that comprises multiple abilities and is critical to independence and autonomy in older adults. Because of its cognitive complexity, Financial Capacity is often the first IADL to show decline in prodromal and clinical Alzheimer's disease and related disorders. Despite its importance, few standardized assessment measures of Financial Capacity exist and there is little, if any, normative data available to evaluate Financial skills in the elderly. The Financial Capacity Instrument-Short Form (FCI-SF) is a brief measure of Financial skills designed to evaluate Financial skills in older adults with cognitive impairment. In the current study, we present age- and education-adjusted normative data for FCI-SF variables in a sample of 1344 cognitively normal, community-dwelling older adults participating in the Mayo Clinic Study of Aging (MCSA) in Olmsted County, Minnesota. Individual FCI-SF raw scores were first converted to age-corrected scaled scores based on position within a cumulative frequency distribution and then grouped within 4 empirically supported and overlapping age ranges. These age-corrected scaled scores were then converted to age- and education-corrected scaled scores using the same methodology. This study has the potential to substantially enhance Financial Capacity evaluations of older adults through the introduction of age- and education-corrected normative data for the FCI-SF by allowing clinicians to: (a) compare an individual's performance to that of a sample of similar age and education peers, (b) interpret various aspects of Financial Capacity relative to a normative sample, and (c) make comparisons between these aspects. (PsycINFO Database Record

  • mri volume of the medial frontal cortex predicts Financial Capacity in patients with mild alzheimer s disease
    Brain Imaging and Behavior, 2013
    Co-Authors: Luke E. Stoeckel, Christopher C. Stewart, Kristen L. Triebel, Ozioma C. Okonkwo, Roy C. Martin, Katherine Belue, Jacquelynn N. Copeland, Randall H Griffith, Jan Den A Hollander, Lindy E. Harrell
    Abstract:

    Persons with mild Alzheimer’s disease (AD) have significant deficits in Financial abilities. This study examined the relationship between brain structure volumes, cognition, and Financial Capacity in patients with mild AD. Sixteen mild AD patients and 16 older adult comparisons completed the Financial Capacity Instrument (FCI), a psychometric measure of Financial abilities, and also underwent magnetic resonance imaging (MRI) to obtain volumes of the bilateral hippocampi, angular gyri, precunei, and medial and dorsolateral frontal cortices. Mild AD patients performed significantly below comparisons on the FCI and had significantly smaller hippocampi. Among mild AD patients, FCI performance was moderately correlated with frontal (medial and dorsolateral frontal cortex) and posterior (angular gyri and precunei) cortical volumes. Stepwise regression demonstrated that medial frontal cortex volume predicted FCI score. The relationship between medial frontal cortex volume and overall FCI score was partially mediated by two measures of simple attention (DRS Attention, DRS Construction). The findings suggest that medial frontal cortex atrophy and associated declines in simple attention play an increasingly important role in declining Financial skills in patients with mild AD.

  • magnetic resonance imaging volume of the angular gyri predicts Financial skill deficits in people with amnestic mild cognitive impairment
    Journal of the American Geriatrics Society, 2010
    Co-Authors: Randall H Griffith, Christopher C. Stewart, Ozioma C. Okonkwo, Roy C. Martin, Katherine Belue, Jacquelynn N. Copeland, Jan Den A Hollander, Lindy E. Harrell, Luke E. Stoeckel, John C Brockington
    Abstract:

    OBJECTIVES: To better understand how brain atrophy in amnestic mild cognitive impairment (MCI) as measured using magnetic resonance imaging (MRI) volumetrics could affect instrumental activities of daily living (IADLs) such as Financial abilities. DESIGN: Controlled, matched-sample, cross-sectional analysis regressing MRI volumetrics with Financial performance measures. SETTING: University medical and research center. PARTICIPANTS: Thirty-eight people with MCI and 28 older adult controls. MEASUREMENTS: MRI volumetric measurement of the hippocampi, angular gyri, precunei, and medial frontal lobes. Participants also completed neuropsychological tests and the Financial Capacity Instrument (FCI). RESULTS: Correlations were performed between FCI scores and MRI volumes in the group with MCI. People with MCI performed significantly below controls on the FCI and had significantly smaller hippocampi. Among people with MCI, performance on the FCI was moderately correlated with angular gyri and precunei volumes. Regression models demonstrated that angular gyrus volumes were predictive of FCI scores. Tests of mediation showed that measures of arithmetic and possibly attention partially mediated the relationship between angular gyrus volume and FCI score. CONCLUSION: Impaired Financial abilities in amnestic MCI correspond with volume of the angular gyri as mediated by arithmetic knowledge. The findings suggest that early neuropathology within the lateral parietal region in MCI leads to a breakdown of cognitive abilities that affect everyday Financial skills. The findings have implications for diagnosis and clinical care of people with MCI and AD.

Randall H Griffith - One of the best experts on this subject based on the ideXlab platform.

  • mri volume of the medial frontal cortex predicts Financial Capacity in patients with mild alzheimer s disease
    Brain Imaging and Behavior, 2013
    Co-Authors: Luke E. Stoeckel, Christopher C. Stewart, Kristen L. Triebel, Ozioma C. Okonkwo, Roy C. Martin, Katherine Belue, Jacquelynn N. Copeland, Randall H Griffith, Jan Den A Hollander, Lindy E. Harrell
    Abstract:

    Persons with mild Alzheimer’s disease (AD) have significant deficits in Financial abilities. This study examined the relationship between brain structure volumes, cognition, and Financial Capacity in patients with mild AD. Sixteen mild AD patients and 16 older adult comparisons completed the Financial Capacity Instrument (FCI), a psychometric measure of Financial abilities, and also underwent magnetic resonance imaging (MRI) to obtain volumes of the bilateral hippocampi, angular gyri, precunei, and medial and dorsolateral frontal cortices. Mild AD patients performed significantly below comparisons on the FCI and had significantly smaller hippocampi. Among mild AD patients, FCI performance was moderately correlated with frontal (medial and dorsolateral frontal cortex) and posterior (angular gyri and precunei) cortical volumes. Stepwise regression demonstrated that medial frontal cortex volume predicted FCI score. The relationship between medial frontal cortex volume and overall FCI score was partially mediated by two measures of simple attention (DRS Attention, DRS Construction). The findings suggest that medial frontal cortex atrophy and associated declines in simple attention play an increasingly important role in declining Financial skills in patients with mild AD.

  • magnetic resonance imaging volume of the angular gyri predicts Financial skill deficits in people with amnestic mild cognitive impairment
    Journal of the American Geriatrics Society, 2010
    Co-Authors: Randall H Griffith, Christopher C. Stewart, Ozioma C. Okonkwo, Roy C. Martin, Katherine Belue, Jacquelynn N. Copeland, Jan Den A Hollander, Lindy E. Harrell, Luke E. Stoeckel, John C Brockington
    Abstract:

    OBJECTIVES: To better understand how brain atrophy in amnestic mild cognitive impairment (MCI) as measured using magnetic resonance imaging (MRI) volumetrics could affect instrumental activities of daily living (IADLs) such as Financial abilities. DESIGN: Controlled, matched-sample, cross-sectional analysis regressing MRI volumetrics with Financial performance measures. SETTING: University medical and research center. PARTICIPANTS: Thirty-eight people with MCI and 28 older adult controls. MEASUREMENTS: MRI volumetric measurement of the hippocampi, angular gyri, precunei, and medial frontal lobes. Participants also completed neuropsychological tests and the Financial Capacity Instrument (FCI). RESULTS: Correlations were performed between FCI scores and MRI volumes in the group with MCI. People with MCI performed significantly below controls on the FCI and had significantly smaller hippocampi. Among people with MCI, performance on the FCI was moderately correlated with angular gyri and precunei volumes. Regression models demonstrated that angular gyrus volumes were predictive of FCI scores. Tests of mediation showed that measures of arithmetic and possibly attention partially mediated the relationship between angular gyrus volume and FCI score. CONCLUSION: Impaired Financial abilities in amnestic MCI correspond with volume of the angular gyri as mediated by arithmetic knowledge. The findings suggest that early neuropathology within the lateral parietal region in MCI leads to a breakdown of cognitive abilities that affect everyday Financial skills. The findings have implications for diagnosis and clinical care of people with MCI and AD.

  • clinical interview assessment of Financial Capacity in older adults with mild cognitive impairment and alzheimer s disease
    Journal of the American Geriatrics Society, 2009
    Co-Authors: Daniel C Marson, Roy C. Martin, Randall H Griffith, Scott Snyder, Virginia G Wadley, Patricia S Goode, Cleveland F Kinney, Anthony P Nicholas, Terri Steele, Britt Anderson
    Abstract:

    OBJECTIVES: To investigate Financial Capacity in patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) using a clinician interview approach. DESIGN: Cross-sectional. SETTING: Tertiary care medical center. PARTICIPANTS: Healthy older adults (n 575) and patients with amnestic MCI (n 558), mild AD (n 597), and moderate AD (n 531). MEASUREMENTS: The investigators and five study physicians developed a conceptually based, semistructured clinical interview for evaluating seven core Financial domains and overall Financial Capacity (Semi-Structured Clinical Interview for Financial Capacity; SCIFC). For each participant, a physician made Capacity judgments (capable, marginally capable, or incapable) for each Financial domain and for overall Capacity. RESULTS: Study physicians made more than 11,000 Capacity judgments across the study sample (N 5261). Very good interrater agreement was obtained for the SCIFC judgments. Increasing proportions of marginal and incapable judgment ratings were associated with increasing disease severity across the four study groups. For overall Financial Capacity, 95% of physician judgments for older controls were rated as capable, compared with 82% for patients with MCI, 26% for patients with mild AD, and 4% for patients with moderate AD. CONCLUSION: Physicians and other clinicians can reliably evaluate Financial Capacity in cognitively impaired older adults using a relatively brief, semistructured clinical interview. Patients with MCI have mild impairment in Financial Capacity, those with mild AD have emerging global impairment, and those with moderate AD have advanced global impairment. Patients with MCI and their families should proactively engage in Financial and legal planning, given these patients’ risk of developing AD and accelerated loss of Financial abilities. J Am Geriatr Soc 57:806–814, 2009.

  • neurocognitive predictors of Financial Capacity across the dementia spectrum normal aging mild cognitive impairment and alzheimer s disease
    Journal of The International Neuropsychological Society, 2009
    Co-Authors: Megan G Sherod, Katherine Belue, Jacquelynn N. Copeland, Randall H Griffith, Lindy E. Harrell, Edward Zamrini, Sara Krzywanski, David G Clark, John C Brockington, Richard E Powers
    Abstract:

    Financial Capacity is a complex instrumental activity of daily living critical to independent functioning of older adults and sensitive to impairment in patients with amnestic mild cognitive impairment (MCI) and Alzheimer’s disease (AD). However, little is known about the neurocognitive basis of Financial impairment in dementia. We developed cognitive models of Financial Capacity in cognitively healthy older adults (n = 85) and patients with MCI (n = 113) and mild AD (n = 43). All participants were administered the Financial Capacity Instrument (FCI) and a neuropsychological test battery. Univariate correlation and multiple regression procedures were used to develop cognitive models of overall FCI performance across groups. The control model (R2 = .38) comprised (in order of entry) written arithmetic skills, delayed story recall, and simple visuomotor sequencing. The MCI model (R2 = .69) comprised written arithmetic skills, visuomotor sequencing and set alternation, and race. The AD model (R2 = .65) comprised written arithmetic skills, simple visuomotor sequencing, and immediate story recall. Written arithmetic skills (WRAT-3 Arithmetic) was the primary predictor across models, accounting for 27% (control model), 46% (AD model), and 55% (MCI model) of variance. Executive function and verbal memory were secondary model predictors. The results offer insight into the cognitive basis of Financial Capacity across the dementia spectrum of cognitive aging, MCI, and AD.

  • neurocognitive predictors of Financial Capacity across the dementia spectrum normal aging mild cognitive impairment and alzheimer s disease
    Journal of The International Neuropsychological Society, 2009
    Co-Authors: Megan G Sherod, Katherine Belue, Jacquelynn N. Copeland, Randall H Griffith, Lindy E. Harrell, Edward Zamrini, Sara Krzywanski, David G Clark, John C Brockington, Richard E Powers
    Abstract:

    Financial Capacity is a complex instrumental activity of daily living critical to independent functioning of older adults and sensitive to impairment in patients with amnestic mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, little is known about the neurocognitive basis of Financial impairment in dementia. We developed cognitive models of Financial Capacity in cognitively healthy older adults (n = 85) and patients with MCI (n = 113) and mild AD (n = 43). All participants were administered the Financial Capacity Instrument (FCI) and a neuropsychological test battery. Univariate correlation and multiple regression procedures were used to develop cognitive models of overall FCI performance across groups. The control model (R2 = .38) comprised (in order of entry) written arithmetic skills, delayed story recall, and simple visuomotor sequencing. The MCI model (R2 = .69) comprised written arithmetic skills, visuomotor sequencing and set alternation, and race. The AD model (R2 = .65) comprised written arithmetic skills, simple visuomotor sequencing, and immediate story recall. Written arithmetic skills (WRAT-3 Arithmetic) was the primary predictor across models, accounting for 27% (control model), 46% (AD model), and 55% (MCI model) of variance. Executive function and verbal memory were secondary model predictors. The results offer insight into the cognitive basis of Financial Capacity across the dementia spectrum of cognitive aging, MCI, and AD.

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  • mri volume of the medial frontal cortex predicts Financial Capacity in patients with mild alzheimer s disease
    Brain Imaging and Behavior, 2013
    Co-Authors: Luke E. Stoeckel, Christopher C. Stewart, Kristen L. Triebel, Ozioma C. Okonkwo, Roy C. Martin, Katherine Belue, Jacquelynn N. Copeland, Randall H Griffith, Jan Den A Hollander, Lindy E. Harrell
    Abstract:

    Persons with mild Alzheimer’s disease (AD) have significant deficits in Financial abilities. This study examined the relationship between brain structure volumes, cognition, and Financial Capacity in patients with mild AD. Sixteen mild AD patients and 16 older adult comparisons completed the Financial Capacity Instrument (FCI), a psychometric measure of Financial abilities, and also underwent magnetic resonance imaging (MRI) to obtain volumes of the bilateral hippocampi, angular gyri, precunei, and medial and dorsolateral frontal cortices. Mild AD patients performed significantly below comparisons on the FCI and had significantly smaller hippocampi. Among mild AD patients, FCI performance was moderately correlated with frontal (medial and dorsolateral frontal cortex) and posterior (angular gyri and precunei) cortical volumes. Stepwise regression demonstrated that medial frontal cortex volume predicted FCI score. The relationship between medial frontal cortex volume and overall FCI score was partially mediated by two measures of simple attention (DRS Attention, DRS Construction). The findings suggest that medial frontal cortex atrophy and associated declines in simple attention play an increasingly important role in declining Financial skills in patients with mild AD.

  • magnetic resonance imaging volume of the angular gyri predicts Financial skill deficits in people with amnestic mild cognitive impairment
    Journal of the American Geriatrics Society, 2010
    Co-Authors: Randall H Griffith, Christopher C. Stewart, Ozioma C. Okonkwo, Roy C. Martin, Katherine Belue, Jacquelynn N. Copeland, Jan Den A Hollander, Lindy E. Harrell, Luke E. Stoeckel, John C Brockington
    Abstract:

    OBJECTIVES: To better understand how brain atrophy in amnestic mild cognitive impairment (MCI) as measured using magnetic resonance imaging (MRI) volumetrics could affect instrumental activities of daily living (IADLs) such as Financial abilities. DESIGN: Controlled, matched-sample, cross-sectional analysis regressing MRI volumetrics with Financial performance measures. SETTING: University medical and research center. PARTICIPANTS: Thirty-eight people with MCI and 28 older adult controls. MEASUREMENTS: MRI volumetric measurement of the hippocampi, angular gyri, precunei, and medial frontal lobes. Participants also completed neuropsychological tests and the Financial Capacity Instrument (FCI). RESULTS: Correlations were performed between FCI scores and MRI volumes in the group with MCI. People with MCI performed significantly below controls on the FCI and had significantly smaller hippocampi. Among people with MCI, performance on the FCI was moderately correlated with angular gyri and precunei volumes. Regression models demonstrated that angular gyrus volumes were predictive of FCI scores. Tests of mediation showed that measures of arithmetic and possibly attention partially mediated the relationship between angular gyrus volume and FCI score. CONCLUSION: Impaired Financial abilities in amnestic MCI correspond with volume of the angular gyri as mediated by arithmetic knowledge. The findings suggest that early neuropathology within the lateral parietal region in MCI leads to a breakdown of cognitive abilities that affect everyday Financial skills. The findings have implications for diagnosis and clinical care of people with MCI and AD.

  • neurocognitive predictors of Financial Capacity across the dementia spectrum normal aging mild cognitive impairment and alzheimer s disease
    Journal of The International Neuropsychological Society, 2009
    Co-Authors: Megan G Sherod, Katherine Belue, Jacquelynn N. Copeland, Randall H Griffith, Lindy E. Harrell, Edward Zamrini, Sara Krzywanski, David G Clark, John C Brockington, Richard E Powers
    Abstract:

    Financial Capacity is a complex instrumental activity of daily living critical to independent functioning of older adults and sensitive to impairment in patients with amnestic mild cognitive impairment (MCI) and Alzheimer’s disease (AD). However, little is known about the neurocognitive basis of Financial impairment in dementia. We developed cognitive models of Financial Capacity in cognitively healthy older adults (n = 85) and patients with MCI (n = 113) and mild AD (n = 43). All participants were administered the Financial Capacity Instrument (FCI) and a neuropsychological test battery. Univariate correlation and multiple regression procedures were used to develop cognitive models of overall FCI performance across groups. The control model (R2 = .38) comprised (in order of entry) written arithmetic skills, delayed story recall, and simple visuomotor sequencing. The MCI model (R2 = .69) comprised written arithmetic skills, visuomotor sequencing and set alternation, and race. The AD model (R2 = .65) comprised written arithmetic skills, simple visuomotor sequencing, and immediate story recall. Written arithmetic skills (WRAT-3 Arithmetic) was the primary predictor across models, accounting for 27% (control model), 46% (AD model), and 55% (MCI model) of variance. Executive function and verbal memory were secondary model predictors. The results offer insight into the cognitive basis of Financial Capacity across the dementia spectrum of cognitive aging, MCI, and AD.

  • neurocognitive predictors of Financial Capacity across the dementia spectrum normal aging mild cognitive impairment and alzheimer s disease
    Journal of The International Neuropsychological Society, 2009
    Co-Authors: Megan G Sherod, Katherine Belue, Jacquelynn N. Copeland, Randall H Griffith, Lindy E. Harrell, Edward Zamrini, Sara Krzywanski, David G Clark, John C Brockington, Richard E Powers
    Abstract:

    Financial Capacity is a complex instrumental activity of daily living critical to independent functioning of older adults and sensitive to impairment in patients with amnestic mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, little is known about the neurocognitive basis of Financial impairment in dementia. We developed cognitive models of Financial Capacity in cognitively healthy older adults (n = 85) and patients with MCI (n = 113) and mild AD (n = 43). All participants were administered the Financial Capacity Instrument (FCI) and a neuropsychological test battery. Univariate correlation and multiple regression procedures were used to develop cognitive models of overall FCI performance across groups. The control model (R2 = .38) comprised (in order of entry) written arithmetic skills, delayed story recall, and simple visuomotor sequencing. The MCI model (R2 = .69) comprised written arithmetic skills, visuomotor sequencing and set alternation, and race. The AD model (R2 = .65) comprised written arithmetic skills, simple visuomotor sequencing, and immediate story recall. Written arithmetic skills (WRAT-3 Arithmetic) was the primary predictor across models, accounting for 27% (control model), 46% (AD model), and 55% (MCI model) of variance. Executive function and verbal memory were secondary model predictors. The results offer insight into the cognitive basis of Financial Capacity across the dementia spectrum of cognitive aging, MCI, and AD.

  • declining Financial Capacity in patients with mild alzheimer disease a one year longitudinal study
    American Journal of Geriatric Psychiatry, 2008
    Co-Authors: Roy C. Martin, Katherine Belue, Randall H Griffith, Lindy E. Harrell, Edward Zamrini, Britt Anderson, Alfred A Bartolucci, Daniel C Marson
    Abstract:

    Objective The objective of this study was to investigate change over time in Financial abilities in patients with mild Alzheimer disease (AD). Methods The authors conducted a prospective 1-year longitudinal study at a large southern U.S. metropolitan-area medical school university. Participants included healthy older adults (N = 63) and patients with mild AD (N = 55). The authors conducted a standardized performance measure of Financial Capacity. Performance was assessed on 18 Financial tasks, nine domains of Financial activity, and overall Financial Capacity. Capacity outcomes classifications (capable, marginally capable, or incapable) for domains and overall performance were made using cut scores referenced to comparison group performance. Results At baseline, patients with mild AD performed significantly below healthy older adults on 16 of 18 tasks, on all nine domains, and on overall Financial Capacity. At one-year follow up, comparison group performance was stable on all variables. In contrast, patients with mild AD showed substantial declines in overall Financial Capacity, on eight of nine domains, and on 12 of 18 tasks. Similarly, the proportion of the mild AD group classified as marginally capable and incapable increased substantially over one year for the two overall scores and for five Financial domains. Conclusions Financial Capacity is already substantially impaired in patients with mild AD at baseline and undergoes rapid additional decline over one year. Relative to the comparison group, overall Financial Capacity performance in the AD group declined 10%, from approximately 80% of the comparison group performance at baseline to 70% at follow up. Financial skills showed differential rates of decline on both simple and complex tasks. Of clinical and public policy interest was the declining judgment of patients with mild AD regarding simple fraud schemes. The study supports the importance of prompt Financial supervision and planning for patients newly diagnosed with AD.