Losing the ability to keep track of a checking account may be one of the early signals that an older person is developing Alzheimer's Disease, UAB researchers found in a study to be published today.
About 20 percent of people over age 70 have 'mild cognitive impairment' -- a transition stage between the normal memory decline that comes with aging and possible Alzheimer's disease or other dementias.
Not all people with MCI develop Alzheimer's, so University of Alabama at Birmingham researchers have sought ways to distinguish which MCI patients are at risk of the disease.
"Declining financial skills are detectable in patients with mild cognitive impairment in the year before their conversion to Alzheimer's disease," Daniel Marson said of the study. Marson directs the UAB Alzheimer's Disease Center, and is a co-author of the paper published in the medical journal Neurology
The study required the help of volunteer patients from metro Birmingham.
Seventy-six were normal older people, with an average age of 67. Eighty-seven others had MCI, and their average age was 70.
All of these volunteers took the UAB-developed Financial Capacity Instrument -- a test of their ability to count coins and currency, balance a checkbook, pay bills, prepare bills for mailing, and understand a bank statement. A year later, they took the FCI test a second time.
Normal patients showed no decline in their scores 12 months later.
In the meantime, 25 of the MCI patients had progressed to Alzheimer's disease, while 67 did not. The 67 "non-converters" had no decline in their average FCI scores.
But the 25 "converters" had a significant decline -- particularly in the task of checkbook management.
When researchers looked back at the first batch of tests taken a year earlier, they found the converters showed significantly lower scores as a group when compared with both normal and non-converter patients. This lower score was particularly seen in the task of using a checkbook to make a payment and using a check register to record that transaction.
"Financial capacity has emerged as a key activity of daily living in understanding ... decline in patients with MCI," Marson said.
This may serve as a clue of future change for doctors. It also means that families need to be careful, Marson said.
The family may need to oversee an MCI patient's checking transactions, or ask the bank to let them know of problems such as bills being paid twice. They might also consider requiring a co-signer for checks over a certain amount.
As many as 5.3 million people in the United States are living with Alzheimer's, according to the Alzheimer's Association, a voluntary health organization based in Chicago. Alzheimer's and other dementias cost Medicare, Medicaid and businesses more than $148 billion in direct and indirect costs each year.