Abstract

Objective: To investigate financial skills in preclinical Alzheimer's disease (AD) using a new short form measure of financial capacity. Method: In collaboration with the Mayo Clinic Study of Aging, we recruited 94 cognitively normal, community dwelling older adults age 70+ in Olmsted County, Minnesota. All participants completed 11C Pittsburgh compound B PET imaging (PiB), and a short-form version of the Financial Capacity Instrument (FCI-SF). The FCI-SF measures performance accuracy on a series of everyday financial tasks, and also measures time to completion (in seconds) of four specific tasks: a medical deductible calculation, a simple income tax calculation, completion of a single-item checkbook/register task, and completion of a three-item checkbook/register task. We compared amyloid positive and negative cognitively normal subjects on their FCI-SF total performance score, and on the four timing variables, using a Rank Sum test. Results: Amyloid imaging resulted in a subdivision of the sample into groups of amyloid positive (n = 26) and amyloid negative cognitively normal subjects (n = 68). FCI-SF total score performance did not differ across groups (p = 0.47). However, the amyloid positive group was slower completing the two checkbook tasks (composite time) (p = .045), and the four financial tasks as a whole (composite time) (p = .017). Conclusion(s): Older cognitively normal subjects with a biomarker for preclinical AD performed equivalently with amyloid negative older subjects in accurately conducting different everyday financial tasks, but showed significantly slower time completing the tasks. These findings suggest that diminished processing speed is an initial preclinical change signaling future financial declines in patients with AD.