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Trouble managing money can be an early sign of dementia

Trouble managing money can be an early sign of dementia
30th May 2019

When spending time with an elderly relative, it can be difficult to know whether difficulties in completing everyday tasks are inevitable parts of ageing or the early stages of dementia. Now, scientists at Duke University Medical Centre are saying that issues with money management are something to look out for.

They say that problems counting change or balancing a ledger could be the first signs that a person has a neurodegenerative disease. The researchers have found that such issues can be correlated to the amount of proteins built up in the brain.

So-called tau proteins are the most common cause of dementia and their build-up in the brain leads nerve cells to lose function and eventually die. In turn, this causes the brain to shrink, which has a negative impact on memory.

Dr Murali Doraiswamy, a professor of psychiatry and geriatrics at Duke and senior author of the paper, said: "There has been a misperception that financial difficulty may occur only in the late stages of dementia, but this can happen early and the changes can be subtle.

"The more we can understand adults' financial decision-making capacity and how that may change with ageing, the better we can inform society about those issues."

Dr Doraiswamy and his team ran the Alzheimer's Disease Neuroimaging Initiative to understand the link between difficulties understanding finances and dementia. The longitudinal study involved 243 adults aged between 55 and 90.

Test subjects were made up of some cognitively healthy people, adults with mild memory loss and another group who had been diagnosed with Alzheimer’s. They were asked to complete a series of tests to assess their financial capabilities and then undergo scans to establish levels of beta-amyloid plaques in their brains.

After taking education and other demographics into account, the scientists found that the worse the plaques in a person’s brain were the harder they found it to complete financial tasks. There was no difference in the outcome for male or female participants.

Dr Doraiswamy added: "Little is known about which brain circuits underlie the loss of financial skills in dementia. Given the rise in dementia cases over the coming decades and their vulnerability to financial scams, this is an area of high priority for research."

According to the Alzheimer’s Society, there are around 850,000 people in the UK living with dementia and this figure is expected to rise in coming years. By 2025, it is predicted it will reach one million and then increase further to two million by 2051.

Duke researcher Sierra Tolbert, the study's lead author, highlighted how a financial test being added to the current memory analysis to diagnose dementia could be useful. Early detection of the disease is vital for slowing its progression, as there is currently no cure.

The Duke study used the 20-minute Financial Capacity Instrument-Short Form Test, which could be added to a doctor’s toolkit for diagnosis. It is sensitive enough to detect subtle changes in an individual’s cognitive ability over time.