March 11, 2008

Patients with mild Alzheimer’s disease have a dramatic decline in their ability to manage their finances and make sound financial decisions. The declines may be rapid over a one-year period. The findings, published online in the American Journal of Psychiatry, have strong implications for caregivers and health care providers in the areas of estate planning and fraud prevention.

Researchers at the University of Alabama compared 55 patients with mild Alzheimer’s disease against 63 healthy older adults and followed them for one year. At the beginning of the trial, those with mild Alzheimer’s disease already showed a financial capacity of 80 percent of the capacity of healthy older adults. By the end of the year, those with Alzheimer’s had dropped another 10 percent in their ability to manage finances, equivalent to 70 percent of the capacity of the healthy group.

“After just one year, the mild Alzheimer’s disease group had dropped to 70 percent of the financial capacity demonstrated by the healthy older adult group,” said the study’s lead author, Daniel Marson, J.D., Ph.D., director of the University of Alabama Alzheimer’s Disease Center in the Department of Neurology.

Patients were assessed on a variety of financial skills, including basic monetary skills, checkbook management, bill payment and understanding a bank statement. Tasks varied from simple ones such as identifying specific coins and currency to complex ones such as preparing bills, checks and envelopes for mailing.

Men and women with Alzheimer’s disease showed substantial declines in overall financial capacity on eight of the nine financial domains and on 12 of the 18 financial tasks. Of particular concern was a decline in the ability to recognize telephone or mail fraud.

“Elder fraud is a serious problem, and our findings suggest that even patients with mild Alzheimer’s are at significantly increased risk for becoming victims of fraud,” Dr. Marson said.

Overall, the study found that impairment in financial skills occurs early in Alzheimer’s disease and progresses relatively rapidly over time. Deficits include declines in basic judgment and monetary calculation skills.

The findings underscore the importance of making sure that patients with Alzheimer’s and their families promptly pursue financial planning and transfer financial responsibilities at the time of diagnosis, Dr. Marson said.

Proactive steps by families include finalizing trust and estate arrangements, delegating financial decision-making powers, planning for eventual financial incapacity, and providing increased supervision of existing financial activities. The research was supported by grants from the National Institute on Aging and the National Institute of Mental Health, part of the National Institutes of Health.

For further caregiving tips, visit www.ALZinfo.org, The Alzheimer’s Information Site.

By www.ALZinfo.org, The Alzheimer’s Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.

Sources:

University of Alabama.

Roy Martin, H. Randall Griffith, Katherine Belue, Lindy Harrell, Edward Zamrini, Britt Anderson, Alfred Bartolucci, and Daniel Marson: “Declining Financial Capacity in Patients With Mild Alzheimer Disease: A One-Year Longitudinal Study.” American Journal of Geriatric Psychiatry. Published March, 2008.