As plaque deposits increase in the aging brain, money management falters

DURHAM, NC – Aging adults often show signs of slowing down in the management of their finances, such as calculating their currency when they pay in cash or when holding a ledger.

These changes occur even in adults with good cognitive health. However, the difficulty in managing money can also be a harbinger of dementia and, according to a new Duke study in the Journal of Alzheimer's Disease Prevention, could be correlated to the amount of accumulated protein deposits in the brain.

"There has been a misconception that financial difficulties can only occur in the later stages of dementia, but it can happen early and changes can be subtle," said Murali P. Doraiswamy, MBBS, professor of Psychiatry and Geriatrics to Duke and senior author of the article. "The more we can understand the financial decision-making ability of adults and how that can change with aging, the better we can inform society of these problems."

Results are based on 243 adults aged 55 to 90 participating in a longitudinal study called the Alzheimer's Disease Neuroimaging Initiative, which included financial literacy tests and brain tests to reveal the accumulation of proteins in beta-amyloid plaques.

The study included cognitively-healthy adults, adults with mild impairment of memory (sometimes a precursor to Alzheimer's disease), and adults with a diagnosis of Alzheimer's disease. Alzheimer.

The tests revealed that some financial skills decreased with age and at the earliest stages of mild memory impairment. The decline was similar for men and women. After controlling a person's training and demographics, the scientists discovered that the longer the amyloid plaques were, the better their ability to understand and apply basic financial concepts or to perform tasks such as calculating the balance of an account was degraded.

"Older people hold a disproportionate share of wealth in most countries and about $ 18 trillion in the United States alone," Doraiswamy said. "Little is known about the brain circuits causing the loss of financial skills in dementia.Because of the increase in the number of cases of dementia in the coming decades and their vulnerability in the face of to financial scams, this is a high priority area for research. "

Even cognitively healthy people can develop protein plaques as they age, but plaques can appear years earlier and be more prevalent in people at risk for Alzheimer's disease due to family history. or mild memory disorders, said Doraiswamy.

Most early dementia and Alzheimer's disease tests are memory-based, said Sierra Tolbert, a researcher at Duke University, lead author of the study. An badessment of financial capacity, such as the 20-minute Financial Capability Instrument used in the Duke study, could also be a tool that allows physicians to track a person's cognitive function over time and is sensitive enough to detect even subtle changes,.

"Doctors might consider proactively counseling their patients using this scale, but this scale is not widely used," Tolbert said. "If someone's scores go down, this could be a warning sign.We hope this research will allow more doctors to realize that there are tools capable of measuring changes." subtle over time and possibly help patients and their families protect their loved ones and their finances. "

In addition to Doraiswamy and Tolbert, the authors of the study include Yuhan Liu, Caroline Hellegers, Jeffrey R. Petrella, Michael W. Weiner, and Terence Z. Wong.

This research used data from the Alzheimer's Disease Neuroimaging Initiative, funded by the National Institutes of Health (U01 AG024904) and the US Department of Defense (W81XWH-12-2-0012), as well as the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering, and the contributions of many other organizations. A complete list of contributors and financial information is available with the manuscript.

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