Loss of functional capacities such as driving. medical decision making, and managing financial affairs are inevitable consequences of Alzheimer's's disease (AD). In prior work, we have investigated the capacity of AD patients to consent to medical treatment using psychometric assessment and physician judgments However, little is known about loss of other specific capacities in AD, notably financial capacity. Financial capacity comprises conceptual, pragmatic and judgment abilities whose loss has important functional. Psychological and legal consequences for AD patients and their families In this study, we will theoretically and clinically investigate financial capacity in AD using a sample of 100 older controls and 200 AD patients (100 mild and 100 moderately demented). Financial abilities will be conceptualized along two dimensions: core knowledge type (declarative, procedural, and executive control) and task difficulty (simple, complex).
In Aim 1, we will use this conceptual model and a psychometric assessment instrument FCI) to investigate loss of financial knowledge in AD. We hypothesize that mild AD patients will perform equivalently with controls on FCI tasks involving simple declarative and procedural knowledge, but will be impaired on tasks involving complex financial knowledge and executive control. Moderate AD patients will be paired on all FCI tasks, indicative of more severe and global loss of financial knowledge and executive control. We also hypothesize that loss in AD patients of declarative and procedural knowledge and executive control will correlate with loss of conceptually related neuropsychological functions as tested traditionally.
Aim 1 will thus demonstrate the cognitive structure of financial abilities and specific neuropsychological changes which mediate their breakdown in AD.
In Aim 2, we will clinically investigate domain specific financial capacities in AD patients using physician judgments, the
