UAB's researchers find early indicators for Alzheimer's disease

University of Alabama at BirminghamSep 22 2009

Inability to handle financial transactions or manage money may be an early indicator that a person with mild memory problems soon is likely to develop Alzheimer's disease, according to new research from the University of Alabama at Birmingham (UAB) Alzheimer's Disease Center, part of the Department of Neurology.

The findings, published in the Sept. 22 edition of Neurology, the medical journal of the American Academy of Neurology, examined patients with a condition known as mild cognitive impairment (MCI), thought to be a precursor to Alzheimer's.

The researchers followed 87 people with MCI and 76 controls with no memory problems. The participant's ability to manage certain financial skills was assessed at the beginning of the study and then again one year later, using a UAB-developed tool called the Financial Capacity Instrument (FCI). The skills included understanding a bank statement, balancing a checkbook, paying bills, preparing bills for mailing and counting coins and currency.

During the course of the year, 25 of the MCI patients had progressed to Alzheimer's disease. The overall FCI scores for those 25 participants decreased 6 percent from their original scores and 9 percent for checkbook-management skills. The control group and those MCI patients who did not progress to dementia maintained the level of their FCI scores throughout the year.

"Declining financial skills are detectable in patients with mild cognitive impairment in the year before their conversion to Alzheimer's disease," said Daniel Marson, Ph.D., JD, professor of neurology and director of the UAB Alzheimer's Disease Center. "This indicates that physicians and health-care providers need to watch patients with MCI closely for declining financial skills and advise families and caregivers to take steps to avoid negative financial events."

Marson suggests that caregivers can oversee a patient's checking transactions, contact the patient's bank to detect irregularities such as bills being paid twice or become co-signers on a checking account so that joint signature is required for checks above a certain amount. Online banking and bill payment services are additional options for families.

"Financial capacity has emerged as a key activity of daily living in understanding functional impairment and decline in patients with MCI and dementia," said Marson. "The capacity to manage one's own financial affairs is critical to success in independent living. Impairments in financial skills and judgment are often the first functional changes demonstrated by patients with incipient dementia."