The role of limbic structures in financial abilities of mild cognitive impairment patients

Financial and numerical abilities: patterns of dissociation in neurological and psychiatric diseases

The present work investigates whether financial abilities can be associated with numerical abilities and with general cognitive abilities. We compared performance on numerical and financial tests, and on tests routinely used to measure general cognitive performance, in healthy controls and in a group of people with heterogeneous pathological conditions including mild cognitive impairment, amyotrophic lateral sclerosis, traumatic brain injury, and schizophrenia. Patients showed lower performances in both numerical and financial abilities compared to controls. Numerical and financial skills were positively correlated in both groups, but they correlated poorly with measures of general cognitive functioning. Crucially, only basic financial tasks -such as counting currencies- but not advanced ones -like financial judgments- were associated with numerical or general cognitive functioning in logistic regression analyses. Conversely, advanced financial abilities, but not basic ones, were associated with abstract reasoning. At a qualitative analysis, we found that deficits in numerical and financial abilities might double dissociate. Similarly, we observed double dissociations between difficulties in financial abilities and cognitive deficits. In conclusion, financial abilities may be independent of numerical skills, and financial deficits are not always related to the presence of cognitive difficulties. These findings are important for both clinical and legal practice.

Characterization of diffusion magnetic resonance imaging revealing relationships between white matter disconnection and behavioral disturbances in mild cognitive impairment: a systematic review

White matter disconnection is the primary cause of cognition and affection abnormality in mild cognitive impairment (MCI). Adequate understanding of behavioral disturbances, such as cognition and affection abnormality in MCI, can help to intervene and slow down the progression of Alzheimer's disease (AD) promptly. Diffusion MRI is a non-invasive and effective technique for studying white matter microstructure. This review searched the relevant papers published from 2010 to 2022. Sixty-nine studies using diffusion MRI for white matter disconnections associated with behavioral disturbances in MCI were screened. Fibers connected to the hippocampus and temporal lobe were associated with cognition decline in MCI. Fibers connected to the thalamus were associated with both cognition and affection abnormality. This review summarized the correspondence between white matter disconnections and behavioral disturbances such as cognition and affection, which provides a theoretical basis for the future diagnosis and treatment of AD.

Convergent and distinct neural structural and functional patterns of mild cognitive impairment: a multimodal meta-analysis

Mild cognitive impairment (MCI) is regarded as a transitional stage between normal aging and Alzheimer's disease. Numerous voxel-based morphometry (VBM) and resting-state fMRI (rs-fMRI) studies have provided strong evidence of abnormalities in the structure and intrinsic function of brain regions in MCI. Studies have recently begun to explore their association but have not employed systematic information in this pursuit. Herein, a multimodal meta-analysis was performed, which included 43 VBM datasets (1,247 patients and 1,352 controls) of gray matter volume (GMV) and 42 rs-fMRI datasets (1,468 patients and 1,605 controls) that combined 3 metrics: amplitude of low-frequency fluctuation, the fractional amplitude of low-frequency fluctuation, and regional homogeneity. Compared to controls, patients with MCI displayed convergent reduced regional GMV and altered intrinsic activity, mainly in the default mode network and salience network. Decreased GMV alone in ventral medial prefrontal cortex and altered intrinsic function alone in bilateral dorsal anterior cingulate/paracingulate gyri, right lingual gyrus, and cerebellum were identified, respectively. This meta-analysis investigated complex patterns of convergent and distinct brain alterations impacting different neural networks in MCI patients, which contributes to a further understanding of the pathophysiology of MCI.

Self-awareness for financial decision making abilities is linked to right temporal cortical thickness in older adults

Everyday financial decision making and the awareness of the integrity of one's financial decision making abilities (or financial awareness) are both critical to study in older adults as they can help identify those at risk for making suboptimal financial decisions and prevent financial loss. In the current study, we examined the cognitive and cortical thickness correlates of financial decision making and financial awareness in 59 community-dwelling participants co-enrolled in a larger study (mean age=68.35 years (SD=5.5), mean education=15.91 (SD=2.36), 61% = women, 67% = White, 30% = Black participants). Data from standardized measures of financial decision making and cognition was investigated along with FreeSurfer (v. 5.3) derived thickness regions. Based on metacognitive frameworks, financial awareness was measured along with a well-validated measure of memory awareness. Results revealed that numeracy, executive functioning and vocabulary were associated with financial decision making, whereas in analysis adjusted for financial decision making, memory awareness relative to cognition was most strongly linked to financial awareness. No significant associations between thickness and financial decision making were found. However, both financial and memory awareness were associated with the same right-hemisphere temporal thickness regions underscoring the idea of a common substrate of awareness. Interestingly, our findings converge with the emerging work on financial exploitation in which the right sided temporal regions have been found to play a prominent role. Incorporating the contributing role of self-awareness in various models of financial exploitation will be an important consideration for future studies.

Financial Decision-Making in Neurological Patients

Financial abilities (FA) are a multi-dimensional domain comprising a wide range of conceptual, pragmatical, and judgmental skills ranging from basic abilities, such as bill payment, to high level abilities, such as financial decision-making (FDM). Preserved FDM abilities include the capacity to recognize fraud attempts, and they are fundamental for a person’s independence. Previous studies have reported decreased FDM in older adults and in patients with mild cognitive impairment (MCI), who consequently become more susceptible to fraud attempts. However, FDM has scarcely been investigated in other neurological populations, and it is unclear whether FDM may be predicted by more basic FA. The aim of the present study was to investigate FDM across patients with MCI, Parkinson’s disease (PD), or stroke, as well as healthy controls (HC), and to explore to what extent FDM could be inferred by other FA. We collected FDM and FA performances using the NADL-F short battery. Performances in the NADL-F short subtests were compared among groups. Additionally, the relationship between the scores at the FDM subtest and the performance obtained in other financial subtests of the NADL-F short were investigated for each group of participants. MCI patients performed worse than HC in FDM and in several FA domains. Conversely, FDM was relatively preserved in our sample of PD and stroke patients. In HC, FDM was associated with numeracy and financial knowledge applied to everyday situations, whereas this was true with some basic FA in both MCI and PD patients. No significant association was observed in stroke patients. Our results suggest that FDM is a complex ability, only partially inferable from other FA.

Dyscalculia in Early Adulthood: Implications for Numerical Activities of Daily Living

Numerical abilities are fundamental in our society. As a consequence, poor numerical skills might have a great impact on daily living. This study analyzes the extent to which the numerical deficit observed in young adults with Developmental Dyscalculia (DD) impacts their activities of everyday life. For this purpose, 26 adults with DD and 26 healthy controls completed the NADL, a standardized battery that assesses numerical skills in both formal and informal contexts. The results showed that adults with DD had poorer arithmetical skills in both formal and informal settings. In particular, adults with DD presented difficulties in time and measure estimation as well as money usage in real-world numerical tasks. In contrast, everyday tasks regarding distance estimation were preserved. In addition, the assessment revealed that adults with DD were aware of their numerical difficulties, which were often related to emotional problems and negatively impacted their academic and occupational decisions. Our study highlights the need to design innovative interventions and age-appropriate training for adults with DD to support their numerical skills as well as their social and emotional well-being.

Higher-Level Executive Functions in Healthy Elderly and Mild Cognitive Impairment: A Systematic Review

Mild Cognitive Impairment (MCI) is a clinical syndrome characterized by a moderate decline in one or more cognitive functions with a preserved autonomy in daily life activities. MCI exhibits cognitive, behavioral, psychological symptoms. The executive functions (EFs) are key functions for everyday life and physical and mental health and allow for the behavior to adapt to external changes. Higher-level executive functions develop from basic EFs (inhibition, working memory, attentional control, and cognitive flexibility). They are planning, reasoning, problem solving, and fluid intelligence (Gf). This systematic review investigates the relationship between higher-level executive functions and healthy and pathological aging, assuming the role of executive functions deficits as a predictor of cognitive decline. The systematic review was conducted according to the PRISMA Statement. A total of 73 studies were identified. The results indicate that 65.8% of the studies confirm significant EFs alterations in MCI (56.8% planning, 50% reasoning, 100% problem solving, 71.4% fluid intelligence). These results seem to highlight a strong prevalence of higher-level executive functions deficits in MCI elderly than in healthy elderly.

Numerical activities of daily living: a short version

Specific impairments in numerical functions may cause severe problems in everyday life that cannot be inferred from the available scales evaluating instrumental activities of daily living. The Numerical Activities of Daily living (NADL) is a battery designed to assess the patient's performance in everyday activities involving numbers (Informal Test) and in more scholastic capacities (Formal Test). A downside of this battery is its duration (45 min). The aim of the present study is to build a shorter version of NADL to make it more suitable for clinical and research purposes. The shortening procedure involved only the Formal test, and followed two steps: (i) a correlation of subtests with the general scores, and (ii) an item-analysis within the subtests previously showing higher correlations. Correlations between NADL-Short and NADL original version, and the new cut-offs were calculated. Lastly, the relationship between NADL-Short and other brief cognitive screening tests used in the clinical practice was evaluated in neurological patients and healthy controls. The NADL-Short includes the original Informal Test and the shortened Formal Test. It is a quick and easy clinical tool (15 min) to assess numerical abilities applied to informal and formal situations. It correlates highly with the original battery (Kendall's tau greater than 0.6 across tasks) and the cut-offs correctly identify impaired performance (accuracy of 95% or above). Correlation analysis showed a low positive correlation between NADL-Short and other brief cognitive scales. These findings suggest that it is appropriate to use specific tools to make inferences about a person's numerical abilities.

Predicting financial deficits from a standard neuropsychological assessment: preliminary evidence in mild cognitive impairment

Patients with mild cognitive impairment (MCI) might experience difficulties in numerical and financial abilities of daily living that compromise their autonomy. The aim of the present work was to examine whether specific tests of the standard neuropsychological assessment could be used to predict these deficits in the clinical practice. Thirty-four MCI patients underwent a comprehensive clinical and neuropsychological examination including (1) a complete assessment of financial abilities and (2) a traditional neuropsychological assessment including measures of language, memory, executive functioning, reasoning, attention, and visuospatial abilities. The neuropsychological tests were used as predictors of the performance in everyday financial tasks using logistic regression analysis. Deficits in financial tasks including calculating percentages, using financial concepts and applying financial judgments were significantly predicted by tests of executive functions, language and short-term memory, while deficits in frequently encountered financial tasks activities such as item purchase and reading numbers could not be predicted by standard neuropsychological evaluations. Contingency tables on performance above/below clinical cut-offs evidenced some cases of financial deficits in the absence of cognitive deficits and, vice versa, some patients with cognitive decline did not show financial impairments. These results suggest that while some cognitive functions might be crucial for taking financial decisions, an ad hoc test of financial capacity is essential to make overall inferences about the everyday financial autonomy of MCI patients. This has potential implications for clinical and legal decisions that directly impact the individuals and their families.

Response to a Specific and Digitally Supported Training at Home for Students With Mathematical Difficulties

The present study evaluated the effectiveness of a shortened, specialized, and digitally supported training program for enhancing numerical skills in primary and secondary school children with mathematical difficulty (MD). The participants (n = 57) were randomly assigned to two groups: for the experimental group, the tasks were differentiated and adapted to each student's learning profile. Moreover, children of this group used a Web App (i.e., "I bambini contano" or "Children count" in English) for improving arithmetic fact retrieval at home; for the control group, the difficulty of the activities was graded according to the school curriculum, and this group did not use the Web App. Pre- to post-training measurements showed that children of the experimental group had an improvement significantly higher than the control group, in particular in arithmetic facts and written calculation. Moreover, a follow-up evaluation indicated that the efficacy of the experimental training program lasted up to 2 months after the intervention. The results indicate that a specialized face-to-face intervention along with a digitally supported training at home can benefit children with mathematical learning difficulties.