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Predictors of finance management in dementia: managing bills and taxes matters

  • Clarissa M. Giebel (a1) (a2), Emma Flanagan (a3) and Caroline Sutcliffe (a4)



Finance management skills deteriorate early on in dementia, and can influence the ability to maintain control over personal affairs. The aim of this study was to assess the contributions of different types of cognition and motor functioning to finance management.


Cross-sectional analysis using secondary data.


Community living.


Baseline data from the Uniform Data Set from the National Alzheimer's Coordinating Centers were obtained and extracted up until December 2016.


Measures on everyday functioning (Functional Assessment Questionnaire) and cognition (memory, executive functioning, and language), the Clinical Dementia Rating scale, and questions on Parkinsonian motor symptoms (gait disturbance, falls, tremors, and slowness) were included. Data were analyzed using bivariate correlation and linear regression analyses.


A total of 9,383 participants were included in the analysis (Alzheimers disease (AD) = 8,201; behavioral variant fronto-temporal dementia (bvFTD) = 796; Dementia with Lewy Bodies (DLB) = 386). Cognition and motor functioning varied significantly across AD, bvFTD, and DLB, with poorer motor functioning and poorer finance management skills in DLB than in AD and bvFTD. In the regression models, slowness, verbal fluency, executive functioning, and language, followed by age, gender, and diagnosis accounted for 13.8% of the variation in managing bills, and for 11.4% of the variation in managing taxes.


Maintaining finance management abilities for as long as possible is important for people with dementia, to avoid potential financial exploitation. Findings from this study highlight avenues to pursue to delay deterioration in managing bills and taxes, and help maintain financial control.


Corresponding author

Correspondence should be addressed to: Clarissa M. Giebel, Institute of Psychology, Society, & Health, University of Liverpool, Waterhouse Building Block A, Liverpool, UK. Phone: +44-151-795-5390. Email:


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Armstrong, M. J. et al. (2013). Criteria for the diagnosis of corticobasal degeneration. Neurology, 80, 496.10.1212/WNL.0b013e31827f0fd1
Beerens, H. C. et al. (2016). The association between aspects of daily life and quality of life of people with dementia living in long-term care facilities: a momentary assessment study. International Psychogeriatrics, 28, 13231331.10.1017/S1041610216000466
Bensimon, G., Ludolph, A., Agid, Y., Vidailhet, M., Payan, C., Leigh, P. N. and NNIPPS Study Group. (2009). Riluzole treatment, survival and diagnostic criteria in Parkinson plus disorders: the NNIPPS study. Brain, 132, 156171.10.1093/brain/awn291
Berezuk, C. et al. (2018). Managing money matters: managing finances is associated with functional independence in MCI. International Journal of Geriatric Psychiatry, 33, 517522. doi: 10.1002/gps.4817.
Cahn, D. A. et al. (1998). Component processes to physical and instrumental activities of daily living in Parkinson's disease. Archives of Clinical Neuropsychology, 13, 575583.
De Paula, J. J. et al. (2016). Impairment of fine motor dexterity in mild cognitive impairment and Alzheimer's disease dementia: association with activities of daily living. Revista Brasileira de Psiqiatria, 38, 235238. doi: 10.1590/1516-4446-2015-1874.
Devanand, D. P., Xinhua, L. and Brown, P. J. (2017). Impact of functional deficits in instrumental activities of daily living in mild cognitive impairment: a clinical algorithm to predict progression to dementia. Alzheimer Disease and Associated Disorders, 31, 5561.10.1097/WAD.0000000000000160
Ferman, T. J. et al. (2006). Neuropsychological differentiation of dementia with Lewy bodies from normal aging and Alzheimer's disease. Clinical Neuropsychologist, 20, 623636.10.1080/13854040500376831
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). Mini mental state- a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.10.1016/0022-3956(75)90026-6
Giebel, C. M., Sutcliffe, C. and Challis, D. (2017). Hierarchical decline of the initiative and performance of complex activities of daily living in dementia. Journal of Geriatric Psychiatry and Neurology, 30, 96103.10.1177/0891988716686835
Griffith, H. R. et al. (2003). Impaired financial abilities in mild cognitive impairment: a direct assessment approach. Neurology, 60, 449457.10.1212/WNL.60.3.449
Kaplan, E. F., Goodglass, H. and Weintraub, S. (1983). The Boston Naming Test. Philadelphia: Lea & Febiger.
Kaufer, D. I. et al. (2000). Validation of the NPI-Q, a brief clinical form of the neuropsychiatric inventory. Journal of Neuropsychiatry and Clinical Neurosciences, 12, 233239.10.1176/jnp.12.2.233
Knapskog, A. B., Barca, M. L. and Engedal, K. (2014). Prevalence of depression among memory clinic patients as measured by the Cornell scale of depression in dementia. Aging and Mental Health, 18, 579587.10.1080/13607863.2013.827630
Lichtenberg, P. A. (2016). The intersection of financial exploitation and financial capacity. American Psychologist, 71, 312320.10.1037/a0040192
Manthorpe, J., Samsi, K. and Rapaport, J. (2012). Responding to the financial abuse of people with dementia: a qualitative study of safeguarding experiences in England. International Psychogeriatric, 24, (9), 14541464.10.1017/S1041610212000348
Marson, D. C. et al. (2000). Assessing financial capacity in patients with Alzheimer's disease: a conceputal model and prototype instrument. Archives of Neurology, 57, 877884.10.1001/archneur.57.6.877
Marson, D. C. (2001). Loss of financial competency in dementia: conceptual and empirical approaches. Aging, Neuropsychology, and Cognition, 8, 164181.10.1076/anec.
Martyr, A., Nelis, S. M. and Clare, L. (2014). Predictors of perceived functional ability in early-stage dementia: self-ratings, informant ratings and discrepancy. International Journal of Geriatric Psychiatry, 29, 852862.10.1002/gps.4071
McKeith, I. G. et al. (2006). More severe functional impairment in dementia with lewy bodies than Alzheimer disease is related to extrapyramidal motor dysfunction. American Journal of Geriatric Psychiatry, 14, 582588.10.1097/01.JGP.0000216177.08010.f4
McKhann, G. M. et al. (2011). The diagnosis of dementia due to Alzheimer's disease: recommendations from the national institute on aging – Alzheimer's association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's Dementia, 7, 263269.10.1016/j.jalz.2011.03.005
Moheb, N., Mendez, M. F., Kremen, S. A. and Teng, E. (2017). Executive dysfunction and behavioral symptoms are associated with deficits in instrumental activities of daily living in frontotemporal dementia. Dementia and Geriatric Cognitive Disorders, 43, 8999.10.1159/000455119
Morris, J. C. (1993). The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology, 43, 24122414.10.1212/WNL.43.11.2412-a
Peisah, C., Bhatia, S., Macnab, J. and Brodaty, H. (2016). Knowledge translation regarding financial abuse and dementia for the banking sector: the development and testing of an education tool. International Journal of Geriatric Psychiatry, 31, 702707.10.1002/gps.4379
Peres, K. et al. (2008). Natural history of decline in instrumental activities of daily living performance over the 10 years preceding the clinical diagnosis of dementia: a prospective population-based study. Journal of the American Geriatrics Society, 56, 3744.
Peterson, J. C. et al. (2014). Financial exploitation of older adults: a population-based prevalence study. Journal of General Internal Medicine, 29, 16151623.10.1007/s11606-014-2946-2
Pfeffer, R. I. et al. (1982). Measurement of functional activity in older adults in the community. Journal of Gerontology, 37, 323329.10.1093/geronj/37.3.323
Raskovsky, K. et al. (2011). Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain, 134, 2456—2477.
Razani, J. et al. (2011). Patterns of deficits in daily functioning and cognitive performance of patients with Alzheimer's Disease. Journal of Geriatric Psychiatry and Neurology, 24, 2332.10.1177/0891988710390812
Razani, J., Casas, R., Wong, J. T., Lu, P., Alessi, C. and Josephson, K. (2007). Relationship between executive functioning and activities of daily living in patients with relatively mild dementia. Applied Neuropsychology, 14, 208214.10.1080/09084280701509125
Shao, Z., Janse, E., Visser, K. and Meyer, A. S. (2014). What do verbal fluency tasks measure? Predictors of verbal fluency performance in older adults. Frontiers in Psychology, 5, 772.10.3389/fpsyg.2014.00772
Sherod, M. G. et al. (2009). Neurocognitive predictors of financial capacity across the dementia spectrum: normal aging, mild cognitive impairment, and Alzheimer's disease. Journal of the International Neuropsychological Society, 15, 258267.10.1017/S1355617709090365
Spreng, R. N., Karlawish, J. and Marson, D. C. (2016). Cognitive, social, and neural determinants of diminished decision-making and financial exploitation risk in aging and dementia: a review and new model. Journal of Elder Abuse & Neglect, 28, 320344.10.1080/08946566.2016.1237918
Sudo, F. K. and Laks, J. (2017). Financial capacity in dementia: a systematic review. Aging & Mental Health, 21, 677683.10.1080/13607863.2016.1226761
Wechsler, D., Coalson, D. L. and Raiford, S. E. (1997). WAIS-III: Wechsler Adult Intelligence Scale. San Antonio, TX: Psychological Corporation.
Woodbridge, R. et al. (2016). Use of the physical environment to support everyday activities for people with dementia: a systematic review. Dementia. Epub ahead of print. doi: 10.1177/1471301216648670.
Yoshii, I. et al. (2016). Relationship between dementia degree and gait ability after surgery of proximal femoral fracture: review from clinical pathway with regional alliance data of rural region in Japan. Journal of Orthopaedic Science, 21, 481486.10.1016/j.jos.2016.03.005
Zawacki, T. M. et al. (2002). Behavioral problems as predictors of functional abilities of vascular dementia patients. Journal of Neuropsychiatry and Clinical Neurosciences, 14, 296302.10.1176/jnp.14.3.296


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Predictors of finance management in dementia: managing bills and taxes matters

  • Clarissa M. Giebel (a1) (a2), Emma Flanagan (a3) and Caroline Sutcliffe (a4)


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