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Giannouli V, Milienos FS. Do sex and handedness influence general cognition and financial capacity in patients with aMCI and healthy older adults? Emphasis on women's performance. Porto Biomed J 2024; 9:258. [PMID: 38993949 PMCID: PMC11236399 DOI: 10.1097/j.pbj.0000000000000258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 07/13/2024] Open
Abstract
Objectives The effects of sex and handedness on financial capacity performance remain unexplored both in healthy older adults and in patients with amnestic mild cognitive impairment (aMCI). Methods The aim of this study was to study the effect of the above factors (sex, handedness, and health condition), following a factorial experimental design; hence, eight groups (each with ten individuals) with similar demographic characteristics (age and education level) were formed consisting of right/left-handed, women/men and healthy/not healthy (with a diagnosis of aMCI) older adults. Mini-Mental State Examination (MMSE) was administered as a measure of general cognitive ability, and Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS) was used as an indicator of financial capacity; moreover, GDS-15 was used to assess depressive symptomatology. Self-reports of hand preference were also included. Results Although as expected healthy men and women regardless of their handedness outperformed aMCI patients on MMSE and LCPLTAS, performance on cash transactions, bank statement management, bill payment, financial decision making, and knowledge of personal assets from LCPLTAS is significantly higher for right-handed aMCI women compared with left-handed aMCI women. Conclusions Future research should further elucidate the reasons for this left-handed female patient with aMCI profile in larger groups of patients. This is an exploratory study, and the small sample size limits the strength of conclusions; further studies on this topic are needed.
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Affiliation(s)
- Vaitsa Giannouli
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fotios S. Milienos
- Department of Sociology, Panteion University of Social and Political Sciences, Athens, Greece
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Ariesen AMD, Tucha O, Bangma DF, Fuermaier ABM, Jansen JL, De Deyn PP, Koerts J. Financial capability of people living with Parkinson's disease - A case-control study. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-15. [PMID: 38913538 DOI: 10.1080/23279095.2024.2356658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder affecting 1% of people older than 60 years. One of the abilities that seems vulnerable to the cognitive impairments associated with PD is financial capability. This explorative study aimed to evaluate the extent and type of problems in financial capability of people with PD without a diagnosis of dementia. Participants were 31 people with PD and 62 matched controls. Participants completed an extensive test-battery, including measures for financial capability and cognitive functioning. Compared to controls, the PD-group performed significantly poorer on two financial competence tasks and showed a comparable performance on the other financial capability measures. For 45% of the PD-group, cognitive test performance was indicative of mild cognitive impairment, yet no significant difference was observed in overall cognitive functioning between the PD and control group. In the total sample, only small or medium correlations were found between financial competence and cognition, and between financial capability and the contextual factors of income and financial experience. The findings suggest that in the earlier stages of PD, when cognitive impairments are relatively mild, some problems may be observed in financial competence, yet other domains of financial capability appear less affected. The absence of strong correlations between financial competence and overall cognitive functioning indicates that standard neuropsychological assessments seem inadequate to make financial capability determinations. By offering insight into the financial capability of people in the milder stages of PD, the findings of the present study may aid in the development and provision of tailored support.
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Affiliation(s)
- Akke-Marij D Ariesen
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
| | - Dorien F Bangma
- Novicare, Institution for Elderly Care and Disabled Care, Utrecht, The Netherlands
| | - Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Josephien L Jansen
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Peter P De Deyn
- Department of Neurology and Alzheimer Center Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Laboratory of Neurochemistry and Behavior, University of Antwerp, Antwerp, Belgium
- Department of Neurology and Memory Clinic, Middelheim General Hospital (ZNA), Antwerp, Belgium
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
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Balestrino M, Brugnolo A, Girtler N, Pardini M, Rizzetto C, Alì PA, Cocito L, Schiavetti I. Cognitive impairment assessment through handwriting (COGITAT) score: a novel tool that predicts cognitive state from handwriting for forensic and clinical applications. Front Psychol 2024; 15:1275315. [PMID: 38605845 PMCID: PMC11007210 DOI: 10.3389/fpsyg.2024.1275315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/26/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction Handwriting deteriorates proportionally to the writer's cognitive state. Such knowledge is of special importance in the case of a contested will, where dementia of the testator is claimed, but medical records are often insufficient to decide what the testator's cognitive state really was. By contrast, if the will is handwritten, handwriting analysis allows us to gauge the testator's cognitive state at the precise moment when he/she was writing the will. However, quantitative methods are needed to precisely evaluate whether the writer's cognitive state was normal or not. We aim to provide a test that quantifies handwriting deterioration to gauge a writer's cognitive state. Methods We consecutively enrolled patients who came for the evaluation of cognitive impairment at the Outpatient Clinic for Cognitive Impairment of the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI) of the University of Genoa, Italy. Additionally, we enrolled their caregivers. We asked them to write a short text by hand, and we administered the Mini Mental State Examination (MMSE). Then, we investigated which handwriting parameters correlated with cognitive state as gauged by the MMSE. Results Our study found that a single score, which we called the COGnitive Impairment Through hAndwriTing (COGITAT) score, reliably allows us to predict the writer's cognitive state. Conclusion The COGITAT score may be a valuable tool to gage the cognitive state of the author of a manuscript. This score may be especially useful in contested handwritten wills, where clinical examination of the writer is precluded.
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Affiliation(s)
- Maurizio Balestrino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Brugnolo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Nicola Girtler
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Cristiano Rizzetto
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
| | - Paolo Alessandro Alì
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
| | - Leonardo Cocito
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
| | - Irene Schiavetti
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
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Vittengl JR. Low household income, financial literacy, or financial health: Which is the strongest risk factor and outcome of depressive symptomatology? J Affect Disord 2024; 344:18-24. [PMID: 37820953 DOI: 10.1016/j.jad.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/04/2023] [Accepted: 10/08/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Depression's relations to psychosocial processes are complex, bidirectional, and include financial functioning. The current study compared the extent to which household income, financial literacy (knowledge and skill), and financial health (saving, spending, borrowing, and planning behavior) were risk factors and outcomes of depression. METHODS A United States national sample of working-aged adults (N = 6565) completed self-report measures of financial functioning and depression in years 2020 and 2022. Depression scales assessed both negative (depressive symptoms) and positive (life satisfaction) affective dimensions. RESULTS Lower income, less financial literacy, and especially poorer financial health correlated significantly with more depressive symptoms and lower life satisfaction. Poorer financial health demonstrated the strongest prospective relations with increasing depressive symptoms and decreasing life satisfaction over the two-year retest interval. In parallel, higher depressive symptoms and lower life satisfaction each predicted subsequent decreases in financial health. LIMITATIONS Results from this longitudinal, observational study suggested but could not establish causal connections between depression and financial functioning. The study's novel results require replication before clinical application. CONCLUSIONS More so than low income or limited financial literacy, poor financial health is both a risk factor and potential outcome of depression, including more depressive symptoms and lower life satisfaction. If these findings are replicated, financial health may be an important research and clinical target for depression assessment, prevention, and treatment.
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Affiliation(s)
- Jeffrey R Vittengl
- Department of Psychology, Truman State University, 100 E. Normal St., Kirksville, MO 63501, USA.
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Pietrzak B, Kujawa J, Lipert A. Depressive Disorders, Cognitive and Physical Function of Older People in Early Dementia Detection. Life (Basel) 2023; 13:2010. [PMID: 37895392 PMCID: PMC10608476 DOI: 10.3390/life13102010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Aging is associated with cognitive decline, leading to cognitive and physical impairments, which are risk factors for loss of independence and dementia development. Early diagnosis is beneficial for both, the patient and their family, to avoid long-term consequences. The aim of this study was to analyze the frequency of depressive disorders and their influence on cognitive and physical function of older people in early dementia detection. METHODS There were 852 patients, aged at least 60 years, from the Central Teaching Hospital. The study was conducted between September 2022 and June 2023. The qualified participants were examined using four tools: Geriatric Depression Scale (GDS), Instrumental Activities of Daily Living (IADL), Timed Up and Go (TUG) and Schulman's Clock-Drawing Test. RESULTS Over one-third had depressive disorders. A relationship with p < 0.05 was observed between GDS and IADL: r = -0.61. A relationship with p > 0.05 was observed between GDS and TUG: r = -024. A relationship with p < 0.05 was observed between GDS and CDT: r = 0.74. CONCLUSIONS The first signs of depressive disorders in older people may be considered an indication for further diagnosis of dementia.
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Affiliation(s)
- Beata Pietrzak
- Department of Medical Rehabilitation, Medical University of Lodz, 92-213 Lodz, Poland; (B.P.); (J.K.)
| | - Jolanta Kujawa
- Department of Medical Rehabilitation, Medical University of Lodz, 92-213 Lodz, Poland; (B.P.); (J.K.)
| | - Anna Lipert
- Department of Sports Medicine, Medical University of Lodz, 92-213 Lodz, Poland
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Giannouli V, Tsolaki M. In the Hands of Hypnos: Associations between Sleep, Cognitive Performance and Financial Capacity in aMCI and Mild AD. Sleep Sci 2023; 16:231-236. [PMID: 37425966 PMCID: PMC10325838 DOI: 10.1055/s-0043-1770796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
Objective The aim of this monocentric observational study is to assess whether sleep disorders can predict financial capacity in single-and multiple-domain aMCI (amnestic Mild Cognitive Impairment), mild Alzheimer's Disease (AD), and healthy controls. Methods Older participants from Northern Greece were examined with several neuropsychological tests, including Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). Sleep duration and quality were based on caregiver/family members' reports in the Sleep Disorders Inventory (SDI). Results These preliminary findings coming from 147 participants indicate for the first time that apart from MMSE, complex cognitive functions, such as financial capacity may be also directly linked to the frequency of sleep-disturbed behaviours as indicated by SDI frequency questions, both in aMCI and mild AD. Discussion An urgency for further investigation of the neglected sleep factor should be added in financial capacity assessment protocols.
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Affiliation(s)
- Vaitsa Giannouli
- Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece, Greece
| | - Magda Tsolaki
- Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece, Greece
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Pluck G. The Misguided Veneration of Averageness in Clinical Neuroscience: A Call to Value Diversity over Typicality. Brain Sci 2023; 13:860. [PMID: 37371340 DOI: 10.3390/brainsci13060860] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Research and practice in clinical neurosciences often involve cognitive assessment. However, this has traditionally used a nomothetic approach, comparing the performance of patients to normative samples. This method of defining abnormality places the average test performance of neurologically healthy individuals at its center. However, evidence suggests that neurological 'abnormalities' are very common, as is the diversity of cognitive abilities. The veneration of central tendency in cognitive assessment, i.e., equating typicality with healthy or ideal, is, I argue, misguided on neurodiversity, bio-evolutionary, and cognitive neuroscientific grounds. Furthermore, the use of average performance as an anchor point for normal performance is unreliable in practice and frequently leads to the mischaracterization of cognitive impairments. Examples are explored of how individuals who are already vulnerable for socioeconomic reasons can easily be over-pathologized. At a practical level, by valuing diversity rather than typicality, cognitive assessments can become more idiographic and focused on change at the level of the individual. The use of existing methods that approach cognitive assessment ideographically is briefly discussed, including premorbid estimation methods and informant reports. Moving the focus away from averageness to valuing diversity for both clinical cognitive assessments and inclusion of diverse groups in research is, I argue, a more just and effective way forward for clinical neurosciences.
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Affiliation(s)
- Graham Pluck
- Clinical Cognitive Sciences Laboratory, Faculty of Psychology, Chulalongkorn University, Borommaratchachonnani Srisattaphat Building, 254 Phayathai Road, Bangkok 10330, Thailand
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Brain Volumes and Metacognitive Deficits in Knowledge of Self, Task and Strategies in Mathematics: A Preliminary Pilot One-Year Longitudinal Study in aMCI Patients Compared to Healthy Controls. Diagnostics (Basel) 2023; 13:diagnostics13040680. [PMID: 36832169 PMCID: PMC9955851 DOI: 10.3390/diagnostics13040680] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
Metacognitive knowledge has been little investigated in aMCI patients. The aim of this study is to examine whether there are specific deficits in knowledge of self, task and strategies in mathematical cognition, due its importance for everyday functioning, mainly due to its importance for financial capacity in old age. A total of 24 patients with a diagnosis of aMCI and one-to-one 24 matched individuals (similar age, education and gender) were examined at three time points in a year with a number of neuropsychological tests and a slightly modified version of the Metacognitive Knowledge in Mathematics Questionnaire (MKMQ). We analyzed longitudinal MRI data regarding various brain areas for the aMCI patients. Results indicated that the aMCI group differed in all MKMQ subscale scores at the three time points compared to healthy controls. Correlations were found only for metacognitive avoidance strategies and left and right amygdala volumes at baseline, while after twelve months correlations were found for avoidance and right and left parahippocampal volumes. These preliminary results highlight the role of specific brain regions that could be used as indices in clinical practice for the detection of metacognitive knowledge deficits that are found in aMCI.
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Beneath the Top of the Iceberg: Financial Capacity Deficits in Mixed Dementia with and without Depression. Healthcare (Basel) 2023; 11:healthcare11040505. [PMID: 36833039 PMCID: PMC9956589 DOI: 10.3390/healthcare11040505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Nowadays, controversy exists regarding the influence of comorbid depression on cognition in old age. Additionally, we still know little about the influence of depression in mixed dementia (MD), that is, in cases where there is the co-existence of Alzheimer's disease and vascular dementia (VaD). Given that the assessment of financial capacity is pivotal for independent living as well as in the prevention of financial exploitation and abuse in old age, in this pilot study, we aimed to examine whether comorbid depression in MD patients can influence financial capacity performance. A total of 115 participants were recruited. They were divided into four groups: MD patients with and without depressive symptoms and healthy elderly without depression as well as older adults suffering from depression. Participants were examined with a number of neuropsychological tests, including the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), and Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). The results of this study suggested that financial capacity as measured with LCPLTAS in MD patients was severely impaired when depression co-existed compared to patients suffering only from depression and healthy controls. Deficits in financial capacity in MD and comorbid depression should be a point on which healthcare professionals should focus during neuropsychological assessment in order to prevent financial exploitation.
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Stressful life events, general cognitive performance, and financial capacity in healthy older adults and Alzheimer's disease patients. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2023:10.1007/s40211-022-00451-y. [PMID: 36600106 DOI: 10.1007/s40211-022-00451-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/11/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND The influence of stressful life events on general cognition and for the first time on financial capacity performance of patients with a diagnosis of Alzheimer's disease (AD) and in healthy controls (HC) is assessed. METHODS A total of 268 participants (122 patients and 146 HCs with similar demographics) were examined with a number of neuropsychological tests, including Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), and Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS) for measuring financial capacity. The life change unit (LCU) method was also used. RESULTS HCs reported more stressful events than AD patients before the onset of the disease as the LCU load was higher for them (51.80 vs. 27.50), but in both groups the level of LCU load was far below 100, which is the threshold suggested for the induction of a psychosomatic disorder. The most frequently reported life event for AD patients was increased family arguments (n = 45/122), followed by increase in responsibilities (n = 32/122) and financial difficulties (n = 29/122), while the HC group reported problems within the family (n = 56/146), change in health status (n = 32/146), and a death of a beloved family member (n = 27/146). Regressions indicate no causal role for recent life events in the etiopathogenesis of AD, but an influence only of MMSE and diagnosis on financial capacity. CONCLUSIONS Stressful life events do not seem to be important in financial capacity and relevant vulnerability to financial exploitation for either HCs or AD patients; therefore clinicians should not consider them per se as a possible aggravating factor for financial deficits.
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Giannouli V, Tsolaki M. Neurocognitive disorders and financial altruism: A few or many steps away for financial generosity and self-justification statements to be used in the diagnosis of brain pathology in old age? Psychiatry Clin Neurosci 2023; 77:56-57. [PMID: 36256510 DOI: 10.1111/pcn.13493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/15/2022] [Accepted: 10/11/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Vaitsa Giannouli
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Department of Psychology, University of Western Macedonia, Florina, Greece
| | - Magda Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Giannouli V, Tsolaki M. Is negative affect associated with deficits in financial capacity in nondepressed older adults? A preliminary study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Giannouli V. Does cognition predict the perceptions of older adults regarding self-stigma in seeking help? REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022:S2530-3120(22)00079-0. [PMID: 36460565 DOI: 10.1016/j.rcpeng.2021.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/18/2021] [Indexed: 06/17/2023]
Affiliation(s)
- Vaitsa Giannouli
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Stamovlasis D, Giannouli V, Vaiopoulou J, Tsolaki M. Catastrophe Theory Applied to Neuropsychological Data: Nonlinear Effects of Depression on Financial Capacity in Amnestic Mild Cognitive Impairment and Dementia. ENTROPY (BASEL, SWITZERLAND) 2022; 24:1089. [PMID: 36010753 PMCID: PMC9407425 DOI: 10.3390/e24081089] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
Financial incapacity is one of the cognitive deficits observed in amnestic mild cognitive impairment and dementia, while the combined interference of depression remains unexplored. The objective of this research is to investigate and propose a nonlinear model that explains empirical data better than ordinary linear ones and elucidates the role of depression. Four hundred eighteen (418) participants with a diagnosis of amnestic MCI with varying levels of depression were examined with the Geriatric Depression Scale (GDS-15), the Functional Rating Scale for Symptoms of Dementia (FRSSD), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). Cusp catastrophe analysis was applied to the data, which suggested that the nonlinear model was superior to the linear and logistic alternatives, demonstrating depression contributes to a bifurcation effect. Depressive symptomatology induces nonlinear effects, that is, beyond a threshold value sudden decline in financial capacity is observed. Implications for theory and practice are discussed.
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Affiliation(s)
- Dimitrios Stamovlasis
- School of Philosophy and Education, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Vaitsa Giannouli
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
| | - Julie Vaiopoulou
- Department of Education, University of Nicosia, Nicosia 2417, Cyprus
- School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Magda Tsolaki
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
- Alzheimer Hellas, 54643 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTh), Balkan Center, Buildings A & B, Thessaloniki, Aristotle University of Thessaloniki, 10th km Thessaloniki-Thermi Rd, P.O. Box 8318, 54124 Thessaloniki, Greece
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Giannouli V, Tsolaki M. What Biological Factors, Social Determinants, and Psychological and Behavioral Symptoms of Patients with Mild Alzheimer’s Disease Correlate with Caregiver Estimations of Financial Capacity? Bringing Biases Against Older Women Into Focus. J Alzheimers Dis Rep 2022; 6:503-507. [PMID: 36186725 PMCID: PMC9484131 DOI: 10.3233/adr-220037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/15/2022] [Indexed: 11/15/2022] Open
Abstract
This study examines the connection between biological factors, social determinants, and behavioral and psychological symptoms of dementia (BPSD) and the estimations of financial capacity made by caregivers of mild AD patients in Greece. Financial capacity estimations negatively correlated with biological sex of the patients (female), but Neuropsychiatric Inventory (NPI) scores were statistically lower for older females. BPSD (measured with NPI) was found to negatively correlate with estimates of financial capacity. The existence of delusions-hallucinations was reported in all males. No correlations were found between financial capacity estimations, actual cognitive and financial capacity performance, and all other included biological and social characteristics of the patients as well as their caregivers.
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Affiliation(s)
- Vaitsa Giannouli
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Magda Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Giannouli V, Tsolaki M. Self-Awareness of Cognitive Efficiency, Cognitive Status, Insight, and Financial Capacity in Patients with Mild AD, aMCI, and Healthy Controls: An Intriguing Liaison with Clinical Implications? Neurol Int 2022; 14:628-637. [PMID: 35997360 PMCID: PMC9396975 DOI: 10.3390/neurolint14030051] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 02/04/2023] Open
Abstract
Objectives: This study compares objective measures of cognitive performance with subjective perception of specific performance on neuropsychological tests examining basic cognitive domains, including, for the first time, financial capacity. Additionally, differences in assessment between single- and multiple-domain aMCI, mild AD, and healthy elderly regarding insight are examined. Methods: Participants completed a number of neuropsychological tests and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). After every test, participants were asked to complete the Clinical Insight Rating scale (CIR) and to self-evaluate their performance by comparing it to what they considered as average for people of their age and educational level. Results: These preliminary findings show significant differences in the self-assessment patterns of the four groups in measures of verbal memory, visuospatial perception and memory, executive functions, tests of attention, and financial capacity. Mild AD expressed the highest overestimations, followed by single- and multiple-domain aMCI as well as controls. Accuracy of self-report is not uniform across groups and functional areas. Conclusions: Unawareness of memory deficits in both MCI subtypes is contradictory to subjective memory complaints as being an important component for clinical diagnosis. Financial capacity is overestimated in MCI and mild AD, a finding that has a plethora of clinical and legal implications.
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Harris KL, Mason SL, Barker RA. Exploring the predictors of financial impairment in Huntington's disease using the Enroll-HD dataset. J Neurol 2022; 269:3501-3510. [PMID: 35165768 PMCID: PMC9217841 DOI: 10.1007/s00415-021-10929-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Huntington's disease (HD) is a neurodegenerative disease in which cognitive and behavioural symptoms impair the performance of instrumental activities of daily living, including the handling of finances. We sought to determine the prevalence of financial dysfunction in HD, and the demographic and clinical predictors of such impairments. METHODS We analysed longitudinal data for pre-manifest gene carriers and HD patients from the Enroll-HD dataset. Financial dysfunction was determined by finance-related items in the Total Functional Capacity (TFC) and Functional Assessment (FA) scales. A binary logistical regression model was used to investigate the predictive value of demographic and clinical factors for the development of financial dysfunction. RESULTS Financial impairment was found to be common in HD gene carriers, and over half required financial assistance within 5 years from diagnosis. Cognitive impairment, apathy, unemployment and disease severity predicted financial dysfunction in manifest patients. For pre-manifest patients, the predictors were proximity to disease onset and depression. CONCLUSIONS Loss of financial autonomy is common in HD, and cognitive and psychiatric factors are important in its development. Clinicians must be vigilant to identify patients that may be vulnerable to financial exploitation.
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Affiliation(s)
- Kate L Harris
- Department of Neurology, University of California San Francisco, San Francisco, United States.
| | - Sarah L Mason
- Department of Clinical Neurosciences, John Van Geest Centre for Brain Repair, E.D. Adrian Building, Forvie Site, Robinson Way, Cambridge, CB2 0PY, UK
| | - Roger A Barker
- Department of Clinical Neurosciences, John Van Geest Centre for Brain Repair, E.D. Adrian Building, Forvie Site, Robinson Way, Cambridge, CB2 0PY, UK.,MRC-WT Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
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Giannouli V, Tsolaki M. Liberating older adults from the bonds of vascular risk factors: What is their impact on financial capacity in amnestic mild cognitive impairment? Psychiatry Clin Neurosci 2022; 76:246-250. [PMID: 35262231 DOI: 10.1111/pcn.13348] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/29/2022] [Accepted: 02/28/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is a pressing need to clarify whether vascular risk factors (VRFs) are related to the heterogeneous cognitive performance found in mild cognitive impairment (MCI) and whether the number of VRFs relates to financial capacity impairment in patients with amnestic MCI (aMCI). METHODS A total of 112 participants were divided into three groups: patients with single-domain aMCI, patients with multiple-domain aMCI, and healthy controls (HCs), while taking into consideration whether participants had a diagnosis of one VRF or disease, or more than one VRF or disease. Patients with aMCI with VRFs (one and more than one VRF) and HCs did not differ significantly in age, education, and sex. Mini-Mental State Examination, 15-item Geriatric Depression Scale, and Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS) were administered to all groups. RESULTS Diagnosis (P <0.001) and VRFs (P = 0.006) showed significant main effects on LCPLTAS but no interaction (P = 0.654). Patients with aMCI with high vascular burden were more frequently of the multiple-domain subtype, whereas patients with no vascular burden were more frequently of the single-domain subtype. A larger vascular burden is correlated with lower LCPLTAS scores. DISCUSSION Vascular burden plays an important role in the heterogeneity of aMCI by impairing financial capacity.
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Affiliation(s)
- Vaitsa Giannouli
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Psychology, University of Western Macedonia, Florina, Greece
| | - Magda Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Giannouli V, Stamovlasis D, Tsolaki M. Longitudinal Study of Depression on Amnestic Mild Cognitive Impairment and Financial Capacity. Clin Gerontol 2022; 45:708-714. [PMID: 34983334 DOI: 10.1080/07317115.2021.2017377] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Amnestic mild cognitive impairment (aMCI) among other cognitive deficits also includes impairments in financial capacity, but so far the role of depression in time has not been examined. We aimed to examine the hypothesis that individuals with aMCI and comorbid worsening depression levels would demonstrate greater deficits in financial capacity atone year in relation to multiple-domain aMCI patients with stable levels of depression, aMCI patients without depression and healthy individuals. METHODS Ninety-six Greek women and 24 men aged 54 and older (multiple-domain aMCI with, stable and increased levels of depression at one year, aMCI without depressive symptoms, and cognitively intact elders with and without depression) were examined with the Mini-mental State Examination (MMSE), the Geriatric Depression Scale (GDS-15), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). RESULTS Bootstrapped ANCOVA was implemented. Multiple-domain aMCI patients' performance regarding financial capacity is severely impaired when depression co-exists, resembling the performance of patients with mild Alzheimer's disease, and it declines further when depression deteriorates. CONCLUSIONS Findings contribute to the limited evidence in financial capacity assessment when depression co-exists showing that higher depressive symptom scores are associated with reduced financial capacity scores and deterioration of depressive symptomatology worsens not only general cognitive outcome, but financial capacity in particular. CLINICAL IMPLICATIONS Proactive care for individuals with depression is needed as this condition severely influences financial capacity in aMCI.
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Affiliation(s)
- Vaitsa Giannouli
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Stamovlasis
- School of Philosophy and Education, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Magda Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Giannouli V, Tsolaki M. Frontotemporal dementia and financial capacity: facing the Cerberus of overestimation or underestimation? Australas Psychiatry 2022; 30:41-43. [PMID: 33818175 DOI: 10.1177/10398562211005444] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study investigates the performance of people with frontotemporal dementia (FTD) on objective assessment of financial capacity with comparison to the estimation of financial capacity by both people themselves and their caregivers. METHOD FTD patients and healthy (age/gender/education-matched) controls from Greece underwent cognitive assessment (memory, attention, executive functioning, visuospatial skills, verbal functions), emotional (anxiety, depression), and financial capacity assessment (Legal Capacity for Property Law Transactions Assessment Scale-LCPLTAS). Additionally, they self-reported on their financial performance and a third-party living with the older participants for both groups reported their estimates of financial performance and their anxiety and depression levels. RESULTS Financial capacity in FTD patients is severely impaired compared to controls, but caregivers of FTD patients tend to overestimate the patients' financial performance, a finding that is not related to the caregivers' depression and anxiety levels or other demographics. FTD patients overestimate their financial capacity. CONCLUSION FTD may have significant impact on financial capacity, but people with FTD tend to overestimate their own financial capacity. This study also indicates that families and caregivers tend to overestimate financial capacity in people with FTD. This has implications for the assessment and care planning of people with FTD in clinical settings.
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Affiliation(s)
- Vaitsa Giannouli
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Magda Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Giannouli V, Tsolaki M. Financial Incapacity of Patients with Mild Alzheimer’s Disease: What Neurologists Need to Know about Where the Impairment Lies. Neurol Int 2022; 14:90-98. [PMID: 35076597 PMCID: PMC8788522 DOI: 10.3390/neurolint14010008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/30/2021] [Accepted: 01/07/2022] [Indexed: 11/18/2022] Open
Abstract
Research in the last decade has focused on assessing financial capacity and incapacity mainly in old age, but new research has turned to address the question of how financial incapacity can be predicted by cognitive factors. The aim of this study was to identify which cognitive domains predict financial capacity and the relevant cognitive skills of patients with mild Alzheimer’s disease (AD) in order to assist neurologists in functional assessment and further patient referral. In this study, 109 patients diagnosed with mild AD were examined with a number of neuropsychological tests: Mini-Mental State Examination (MMSE), Functional Rating Scale for Symptoms of Dementia (FRSSD), Functional Cognitive Assessment Scale (FUCAS), Trail Making Test (TMT)-Part B, Rey-Osterrieth Complex Figure Test (ROCFT)-copy condition and delayed recall condition, Rey Auditory Verbal Learning Test (RAVLT), Boston Naming Test, Rivermead Behavioural Memory Test (RBMT), digit span forward and backward, WAIS-R digit symbol substitution test, Neuropsychiatric Inventory (NPI), Geriatric Depression Scale (GDS-15), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). LCPLTAS total score and relevant subdomains were best predicted only by the score of one item coming from MMSE: subtraction of serial sevens. This is the only measure of arithmetic testing in use for the Greek geriatric population. Financial capacity is severely impaired in the group of mild AD patients. In order to prevent financial exploitation cases, neurologists, neuropsychologists, psychiatrists, and geriatrists should pay close attention to the information from the relevant arithmetic question of MMSE, as it is one of the most widely administered screening tests in clinical settings.
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Giannouli V, Tsolaki M. Neuropsychological Performance and Engagement in Estate Planning and Advance Care Planning Preparation of Patients With Neurocognitive Disorders and Healthy Older Adults: Is the Situation Alarming or Reassuring in Greece? Gerontol Geriatr Med 2022; 8:23337214221119053. [PMID: 36046580 PMCID: PMC9421022 DOI: 10.1177/23337214221119053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/11/2022] [Accepted: 07/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background/Objective: This study examined for the first time in Greece, the estate planning and advance care planning (ACP) of healthy older adults and older patients diagnosed with different types of neurocognitive disorders for the presence of a valid will, a durable power of attorney for healthcare, and a living will, while the associations between general cognition, education, depression, actual financial capacity, and demographic and socioeconomic characteristics were examined. Methods: A total of 543 participants were examined with neuropsychological tests including Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). Along with the neuropsychological examination, all participants responded to relevant ACP questions. Results: Surprisingly, the majority of the participants regardless of their diagnostic group did not have a valid will, had not assigned a durable power of attorney for healthcare, and had not a written living will. Logistic regression revealed that biological sex, age, education, marital status, diagnostic group, MMSE, GDS, and actual financial capacity as measured with LCPLTAS did not predict the existence of a valid will, durable power of attorney, and written living will. Conclusions: A diagnosis of AD is not associated with more engagement in ACP as supported by research in USA. Concerns are raised about possible exploitation and abuse of older patients.
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Affiliation(s)
- Vaitsa Giannouli
- Aristotle University of Thessaloniki, Greece.,University of Western Macedonia, Florina, Greece
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Giannouli V, Tsolaki M. Financial Capacity and Illiteracy: Does Education Matter in Amnestic Mild Cognitive Impairment? J Alzheimers Dis Rep 2021; 5:715-719. [PMID: 34755045 PMCID: PMC8543375 DOI: 10.3233/adr-210033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 11/15/2022] Open
Abstract
Neuropsychological assessment in amnestic mild cognitive impairment (aMCI) becomes complicated when education-literacy is taken into consideration. This study sought to explore the potential influence of literacy/illiteracy and education on financial capacity in patients with multiple-domain aMCI. Six groups consisting of aMCI (illiterate-no formal education, literate with low education, and literate with high education) and non-demented controls were examined. Literacy has an effect on financial capacity, as the illiterate aMCI group alone had the lowest scores in a financial capacity test resembling the performance of patients with mild Alzheimer's disease. In controls there was a similar pattern, but all three healthy groups regardless of education scored above the cut-off score for incapacity.
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Affiliation(s)
- Vaitsa Giannouli
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Magda Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Fernandes C, Macedo I, Barbosa F, Marques-Teixeira J. Economic decision-making in the continuum between healthy aging and Alzheimer's Disease: A systematic review of 20 years of research. Neurosci Biobehav Rev 2021; 131:1243-1263. [PMID: 34715151 DOI: 10.1016/j.neubiorev.2021.10.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/23/2021] [Accepted: 10/23/2021] [Indexed: 01/21/2023]
Abstract
The effect of pathological aging on economic decision-making is a topic of major relevance as impairments in this domain place older adults at increased risk for financial abuse. This review aims to characterize decision-making across the continuum that goes from healthy aging to Alzheimer's Dementia. We included 42 studies comparing patients with Mild Cognitive Impairment (MCI) and healthy older adults, patients with Alzheimer's Disease (AD) and healthy older adults, and patients with MCI and patients with AD. Substantial evidence emerged suggesting that both MCI as AD affect economic decision-making. However, a non-negligible number of behavioural tasks failed to find significant differences between patients and controls, and no differences were reported between patients with MCI and AD. On the contrary, measures of financial capacity reached more robust findings, showing that healthy older adults had better performance than patients, while MCI patients showed better performance than AD patients. This review presents the main conclusions that may be drawn from significant findings, as well as the hypotheses and recommendations for future research.
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Affiliation(s)
- Carina Fernandes
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal.
| | - Inês Macedo
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - João Marques-Teixeira
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
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Vascular Dementia, Depression, and Financial Capacity Assessment. Alzheimer Dis Assoc Disord 2021; 35:84-87. [PMID: 32366802 DOI: 10.1097/wad.0000000000000374] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 01/27/2020] [Indexed: 11/26/2022]
Abstract
We still know little about financial capacity, which consists of multiple cognitive domains as well as specific skills, and the influence of depression in patients with vascular dementia (VaD). Participants were divided into 4 groups: (1) VaD with and (2) without depressive symptoms, (3) nondemented elders with and (4) without depression. The participants were examined with the Mini-Mental State Examination (MMSE), the Geriatric Depression Scale (GDS-15), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). The findings extend earlier work in other groups of older patients and indicate that VaD patients' performance in cognitive functioning and financial capacity is severely impaired, while there is a statistically significant difference between depressed and nondepressed VaD patients. Thus, depression negatively influences financial capacity. Depression and mood disorders should be considered in future capacity research with older adults and with larger VaD populations.
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Giannouli V, Tsolaki M. Mild Alzheimer Disease, Financial Capacity, and the Role of Depression: Eyes Wide Shut? Alzheimer Dis Assoc Disord 2021; 35:360-362. [PMID: 33443873 DOI: 10.1097/wad.0000000000000427] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 11/17/2020] [Indexed: 11/26/2022]
Abstract
The aim of this study was to assess whether comorbid depression in patients with mild Alzheimer disease (AD) can influence financial capacity. The sample comprised 109 participants divided into 4 groups: mild AD with and without depressive symptoms, and cognitive normal elderly with and without depression. Participants were examined using a number of neuropsychological tests, with an emphasis on the Mini-Mental State Examination, the 15-item Geriatric Depression Scale, and the Legal Capacity for Property Law Transactions Assessment Scale. Financial capacity ascertained as performance in the Legal Capacity for Property Law Transactions Assessment Scale in the group of mild AD patients was severely impaired when depression coexisted, thus clearly differentiating the mild AD group from mild AD with comorbid depression.
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Affiliation(s)
- Vaitsa Giannouli
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Giannouli V, Tsolaki M. Is Depression or Apathy Playing a Key Role in Predicting Financial Capacity in Parkinson's Disease with Dementia and Frontotemporal Dementia? Brain Sci 2021; 11:brainsci11060785. [PMID: 34198487 PMCID: PMC8231779 DOI: 10.3390/brainsci11060785] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/05/2021] [Accepted: 06/09/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Depression and apathy both affect cognitive abilities, such as thinking, concentration and making decisions in young and old individuals. Although apathy is claimed to be a “core” feature of Parkinson’s disease (PD) and frontotemporal dementia (FTD), it may occur in the absence of depression and vice versa. Thus, the aim of this study is to explore whether depression or apathy better predict financial capacity performance in PD and FTD as well as in nondemented participants. (2) Methods: Eighty-eight participants divided into three groups (PD, FTD and non-demented participants) were examined with the Mini-Mental State Examination (MMSE) and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS)—Full and short form. The Geriatric Depression Scale informant version (GDS-15) and the Irritability-Apathy Scale (IAS) we completed by caregivers. (3) Results: The results indicated that both PD and FTD patients’ general cognitive functioning and financial capacity performance is negatively influenced by apathy and not by depression. (4) Conclusions: Differences in financial capacity performance indicate that apathy should not be disregarded in clinical assessments. Further studies on larger PD and FTD populations are necessary in order to investigate the decisive role of mood factors on financial capacity impairment.
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Affiliation(s)
- Vaitsa Giannouli
- Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece;
- School of Psychology, University of Western Macedonia, 53100 Florina, Greece
- Correspondence:
| | - Magda Tsolaki
- Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece;
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Bangma DF, Tucha O, Tucha L, De Deyn PP, Koerts J. How well do people living with neurodegenerative diseases manage their finances? A meta-analysis and systematic review on the capacity to make financial decisions in people living with neurodegenerative diseases. Neurosci Biobehav Rev 2021; 127:709-739. [PMID: 34058557 DOI: 10.1016/j.neubiorev.2021.05.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/13/2022]
Abstract
Self and proxy reported questionnaires indicate that people living with a neurodegenerative disease (NDD) have more difficulties with financial decision-making (FDM) than healthy controls. Self-reports, however, rely on adequate insight into everyday functioning and might, therefore, be less reliable. The present study provides a comprehensive overview and meta-analysis of studies evaluating FDM in people living with an NDD. For this, the reliability of performance-based tests to consistently identify FDM difficulties in people living with an NDD compared to healthy controls is evaluated. Furthermore, the associations between FDM and disease severity, performances on standard measures of cognition and demographics are evaluated. All 47 included articles, consistently reported lower performances on performance-based FDM tests of people living with an NDD (including Alzheimer's disease, mild cognitive impairment, frontotemporal dementia, Parkinson's disease, multiple sclerosis or Huntington's disease) compared to healthy controls. The majority of studies, however, focused on Alzheimer's disease and mild cognitive impairment (k = 38). FDM performance appears to be related to cognitive decline, specifically in working memory, processing speed and numeracy.
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Affiliation(s)
- Dorien F Bangma
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands; Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands; Department of Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany; Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
| | - Lara Tucha
- Department of Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Peter P De Deyn
- Department of Neurology and Alzheimer Center Groningen, University Medical Center Groningen, Groningen, the Netherlands; Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Department of Neurology and Memory Clinic, Middelheim General Hospital (ZNA), Antwerp, Belgium
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands.
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Giannouli V, Tsolaki M. APOE ɛ4 Allele and Financial Capacity Performance in Mild Alzheimer's Disease: A Pilot Study. J Alzheimers Dis Rep 2021; 5:93-97. [PMID: 33681721 PMCID: PMC7903015 DOI: 10.3233/adr-200254] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This study aims to explore a little investigated topic, i.e., whether the presence of the APOE eɛ4 allele in patients with a diagnosis of mild Alzheimer’s disease (AD) can influence financial capacity. Twenty-eight elders with mild AD carrying the APOEɛ4 allele and 28 matched non-carrier patients were examined with an extensive battery of neuropsychological tests, and a specific test measuring financial capacity: Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). The presence of the APOEɛ4 allele does not differentiate the group of mild AD patients regarding a number of cognitive domains necessary for financial capacity scores as measured by LCPLTAS.
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Affiliation(s)
- Vaitsa Giannouli
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Magda Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Giannouli V, Markopoulou A, Kiosseoglou G, Kosmidis MH. Neuropsychological functioning in patients with interstitial lung disease. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1290-1295. [PMID: 33506719 DOI: 10.1080/23279095.2020.1870465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE We undertook the present study to investigate the cognitive status of patients with interstitial lung disease (ILD) and its relationship to pulmonary function and cardiovascular efficiency. METHOD Fifty-one patients with a diagnosis of ILD [mean duration = 3.13 years (SD = 3.01)] received a respiratory examination, including spirometry and the six-minute walk test, and completed a neuropsychological assessment including several cognitive domains. Eighty-eight healthy individuals matched on age, education, and gender, completed the neuropsychological test battery. RESULTS Patients performed more poorly than their healthy peers on cognitive tasks related to verbal and visual memory, visual perception, and working memory, but not attention, processing speed and executive functioning. Stepwise linear regression analyses showed that exercise-related measures (heart rate, oxygen saturation and distance walked) predicted performance on neuropsychological tests of psychomotor speed, verbal memory and word production. Additionally, an index of pulmonary function, specifically, lung diffusion capacity, predicted performance on selective and sustained attention and word generation. CONCLUSION The present preliminary findings may have implications for the quality of life and treatment compliance of patients with ILD and warrant further study with a larger sample of patients.
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Affiliation(s)
- Vaitsa Giannouli
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Grigoris Kiosseoglou
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Unraveling Ariadne's Thread Into the Labyrinth of aMCI: Depression and Financial Capacity. Alzheimer Dis Assoc Disord 2020; 35:363-365. [PMID: 33136558 DOI: 10.1097/wad.0000000000000417] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 08/08/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND People with amnestic mild cognitive impairment (aMCI) face many daily challenges as memory loss is their predominant cognitive impairment. OBJECTIVES This study examined whether financial capacity can be influenced by comorbid depression in patients with multiple-domain aMCI. MATERIALS AND METHODS The participants included 120 patients in 4 groups: multiple-domain aMCI with and without depressive symptoms, and nondemented elders with and without depression. Participants were examined with the Mini-Mental State Examination, the 15-item Geriatric Depression Scale, and the Legal Capacity for Property Law Transactions Assessment Scale. RESULTS The findings extend earlier work in other groups of older patients and indicate that the performance of patients with multiple-domain aMCI in cognitive functioning and financial capacity is severely impaired when depression coexists, resembling the performance of patients with mild Alzheimer disease. CONCLUSIONS The results support special care for individuals with depression as this condition severely influences financial capacity in aMCI.
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Gill S, Blair M, Kershaw M, Jesso S, MacKinley J, Coleman K, Pantazopoulos K, Pasternak S, Finger E. Financial capacity in frontotemporal dementia and related presentations. J Neurol 2019; 266:1698-1707. [PMID: 31011799 PMCID: PMC6586696 DOI: 10.1007/s00415-019-09317-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 04/04/2019] [Accepted: 04/09/2019] [Indexed: 11/29/2022]
Abstract
Background Changes in financial judgement and skills can herald a neurodegenerative dementia and are a common reason for referral for cognitive neurologic assessment. However, patients with neurodegenerative diseases affecting the frontal or temporal lobes may perform well on standard cognitive tests, complicating clinical determinations about their diagnosis and financial capacity. Methods Forty-five patients with possible or probable FTD or Alzheimer’s disease and 22 healthy controls completed two financial assessment batteries, the FACT and the FCAI. Patients’ performance was compared to study partner estimates of patients’ financial abilities. Results All three patient groups performed worse than controls on both the FACT and the FCAI. Study partners over-estimated the performance of patients with Alzheimer’s disease. Conclusions These initial findings suggest that accurate clinical assessment of financial skills and judgement in patients with possible neurodegenerative dementias requires performance-based assessment. Electronic supplementary material The online version of this article (10.1007/s00415-019-09317-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sascha Gill
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Parkwood Institute, Lawson Health Research Institute, University of Western Ontario, 550 Wellington Rd, London, ON, Canada
| | - Mervin Blair
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Parkwood Institute, Lawson Health Research Institute, University of Western Ontario, 550 Wellington Rd, London, ON, Canada
| | - Mavis Kershaw
- Australian Psychological Society, Melbourne, Australia.,International Association of Applied Psychology, New York, USA.,Australia and New Zealand Association of Psychiatry, Psychology and Law, Melbourne, Australia
| | - Sarah Jesso
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Parkwood Institute, Lawson Health Research Institute, University of Western Ontario, 550 Wellington Rd, London, ON, Canada
| | - Julia MacKinley
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Parkwood Institute, Lawson Health Research Institute, University of Western Ontario, 550 Wellington Rd, London, ON, Canada
| | - Kristy Coleman
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Parkwood Institute, Lawson Health Research Institute, University of Western Ontario, 550 Wellington Rd, London, ON, Canada
| | - Koula Pantazopoulos
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Parkwood Institute, Lawson Health Research Institute, University of Western Ontario, 550 Wellington Rd, London, ON, Canada
| | - Stephen Pasternak
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Parkwood Institute, Lawson Health Research Institute, University of Western Ontario, 550 Wellington Rd, London, ON, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Parkwood Institute, Lawson Health Research Institute, University of Western Ontario, 550 Wellington Rd, London, ON, Canada.
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