Problems Balancing the Checkbook May Signal Early Alzheimer’s

November 23, 2009

November 23, 2009

Whether it’s counting coins, paying bills or balancing the checkbook, money matters are a challenge for anyone with Alzheimer’s disease. Problems handling finances are also often an early warning sign for onset of the illness, new research finds.

The report, from researchers at the University of Alabama and published in the journal Neurology, found that poor money management skills may indicate that a person with mild memory problems will soon develop Alzheimer’s disease.

Researchers compared 76 older people who had no memory problems with 87 seniors who had mild cognitive impairment, or MCI, a somewhat serious form of memory loss that sometimes progresses to Alzheimer’s diseases. The participants were given a money management test at the beginning of the study, and then again after a year. The test included tasks of counting coins, making grocery purchases, using a checkbook, understanding a bank statement, preparing bills for mailing, and detecting situations that may signal financial fraud.

After a year, 25 of the 87 people with MCI had developed Alzheimer’s disease. The researchers found that those who had developed Alzheimer’s tended to score poorly on money management tasks at the start of the study, before they developed Alzheimer’s. They also showed drops over the course of the year. Their scores on checkbook management tasks, which require a variety of mental steps, dropped the most, by 9 percent. Overall, general financial knowledge and skills dropped by 6 percent.

In contrast, those with MCI who didn’t develop Alzheimer’s, as well as those with no memory problems, tended to score higher on the money management tasks at the start. Those skills generally persisted after a year.

“Our findings show that declining money management skills are detectable in patients with MCI in the year prior to developing Alzheimer’s disease,” said Daniel Marson, J.D., Ph.D., the study’s senior author.

The researchers also offer practical advice for family members and other caregivers of those with mild cognitive impairment and possible early Alzheimer’s.

“Doctors should proactively monitor people with MCI for declining financial skills and advise them and their caregivers about steps they can take to watch for signs of poor money management,” Dr. Marson said. “Caregivers should consider overseeing a person’s checking transactions, contacting the person’s bank to find money issues such as bills being paid twice, or become cosigners on the checking account so that both signatures are required for checks written above a certain amount. Online banking and bill payment services are also good options.”

Managing money is a critical component of independent living. Losing those skills can be a source of anxiety and practical distress for anyone with mild cognitive impairment or early Alzheimer’s. Family members, doctors and patients can work together to minimize the risk of financial fraud and to help ease the stress of caregiving in homes touched by Alzheimer’s.

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.


K. L. Triebel, PsD; R. Martin, PhD; H. R. Griffith, PhD; et al: “Declining Financial Capacity in Mild Cognitive Impairment.” Neurology, Vol. 73, September 22, 2009, pages 928-934.


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