Loss of financial capacity in Alzheimer's disease: The role of working memory

Recent research has demonstrated that loss of financial capacity is a commo n consequence of Alzheimer's disease (AD). While progressive cognitive decl ine is a defining feature of AD, the relationship between such decline and loss of financial capacity in AD remains unclear. Working memory may be str ongly associated with financial abilities, as many financial tasks require temporary storage and manipulation of numerical and other data. The present study examined the relationship between financial capacity and working mem ory in AD patients. Participants included 20 AD patients and 23 cognitively intact older controls. Working memory was conceptualized using Baddeley an d colleagues' model, which posits that the three components of the working memory system are the visuospatial sketchpad, phonological loop, and centra l executive system. The present study examined only the latter two componen ts of working memory. Each participant was administered the Financial Capac ity Instrument (FCI), an instrument that directly assesses eight domains of financial activity, and the WAIS-III Working Memory subtests (Digit Span, Arithmetic, Letter-Number Sequencing). AD patients as a group performed sig nificantly below controls on the FCI Total Score and on each of the eight F CI domains and working memory subtests. Within the AD group, measures of th e central executive component of working memory (WAIS-III Digits Backward, Arithmetic, and Letter-Number Sequencing tests) showed strong correlations with the FCI domains of basic monetary skills, checkbook management, bank s tatement management, and bill payment and FCI total score, while a measure of the phonological loop component of working memory (WAIS-III Digits Forwa rd) was not significantly correlated with any FCI domains or with the FCI t otal score. The results suggest that the multiple domains of financial capa city are primarily correlated with the central executive component of worki ng memory.