Financial Management Skills in Aging, MCI and Dementia: Cross Sectional Relationship to 18F-Florbetapir PET Cortical β-amyloid Deposition

  • S. TolbertEmail author
  • Y. Liu
  • C. Hellegers
  • J. R. Petrella
  • M. W. Weiner
  • T. Z. Wong
  • P. Murali Doraiswamy
  • ADNI Study Group
Original Research



There is a need to more fully characterize financial capacity losses in the preclinical and prodromal stages of Alzheimer’s disease (AD) and their pathological substrates.


To test the association between financial skills and cortical β-amyloid deposition in aging and subjects at risk for AD.


Cross-sectional analyses of data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI-3) study conducted across 50 plus sites in the US and Canada.


Multicenter biomarker study.


243 subjects (144 cognitively normal, 79 mild cognitive impairment [MCI], 20 mild AD).


18F-Florbetapir brain PET scans to measure global cortical β-amyloid deposition (SUVr) and the Financial Capacity Instrument Short Form (FCI-SF) to evaluate an individual’s financial skills in monetary calculation, financial concepts, checkbook/register usage, and bank statement usage. There are five sub scores and a total score (range of 0–74) with higher scores indicating better financial skill.


FCI-SF total score was significantly worse in MCI [Cohen’s d= 0.9 (95%CI: 0.6–1.2)] and AD subjects [Cohen’s d=3.1(CI: 2.5–3.7)] compared to normals. Domain scores and completion times also showed significant difference. Across all subjects, higher cortical β-amyloid SUVr was significantly associated with worse FCI-SF total score after co-varying for age, education, and cognitive score [Cohen’s f2=0.751(CI: 0.5–1.1)]. In cognitively normal subjects, after covarying for age, gender, and education, higher β -amyloid PET SUVr was associated with longer task completion time [Cohen’s f2=0.198(CI: 0.06–0.37)].


Using a multicenter study sample, we document that financial capacity is impaired in the prodromal and mild stages of AD and that such impairments are, in part, associated with the extent of cortical β-amyloid deposition. In normal aging, β-amyloid deposition is associated with slowing of financial tasks. These data confirm and extend prior research highlighting the utility of financial capacity assessments in at risk samples.

Key words

Preclinical Alzheimer’s financial capacity amyloid PET 



We are grateful to Dr. Daniel Marson for his valuable insights. Data used in preparation of this article were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database ( As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. Data used in preparation of this article were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database ( As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at:


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Copyright information

© Serdi and Springer Nature Switzerland AG 2019

Authors and Affiliations

  • S. Tolbert
    • 1
    Email author
  • Y. Liu
    • 1
  • C. Hellegers
    • 1
  • J. R. Petrella
    • 1
  • M. W. Weiner
    • 1
  • T. Z. Wong
    • 1
  • P. Murali Doraiswamy
    • 1
  • ADNI Study Group
  1. 1.Departments of Psychiatry, Medicine and Radiology, Duke University Health System; Departments of Radiology and Biomedical Imaging, Medicine, Psychiatry, and NeurologyUniversity of CaliforniaSan FranciscoUSA

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