Neurocognitive Predictors of Financial Capacity in Traumatic Brain Injury

Martin, Roy C.; Triebel, Kristen L.; Dreer, Laura E.; Novack, Thomas A.; Turner, Crystal; Marson, Daniel C.

doi:10.1097/htr.0b013e318273de49

Cited by 37 publications

(25 citation statements)

References 24 publications

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“…Longitudinal studies can provide invaluable insight into the neurocognitive mechanisms underlying the differential trajectories of financial skill decline in MCI and AD. Identification of neurocognitive predictors can provide clinical guidance to healthcare providers called upon to make decisions regarding patients’ capacity to manage finances, and can also facilitate the use of clinical interventions to support the financial abilities of impaired patients (Martin et al, 2012; Schaie, 2005). …”

Section: Introductionmentioning

confidence: 99%

Neurocognitive Predictors of Declining Financial Capacity in Persons with Mild Cognitive Impairment

Niccolai

Triebel

Gerstenecker

et al. 2016

Clinical Gerontologist

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Objective To identify cognitive predictors of declining financial capacity (FC) in persons with mild cognitive impairment (MCI). Methods Participants were 66 cognitively normal older adults and 49 persons with MCI who completed neuropsychological testing and a performance measure of financial capacity (Financial Capacity Instrument; FCI) at baseline and two-year follow-up. We calculated two-year change scores for neuropsychological tests and FCI total score. We examined bivariate correlations between demographic/clinical variables and FCI change score, and between neuropsychological and FCI change scores. The five strongest bivariate correlates were entered into a linear regression analysis to identify longitudinal predictors of financial decline within group. Results Persons with MCI showed significant decline on the FCI and most cognitive variables, while controls demonstrated relatively stable performance. For persons with MCI, education correlated with FCI change score. The top four cognitive variable-FCI change score correlations were written arithmetic, confrontation naming, immediate visual memory, and visual attention. In the regression model, written arithmetic was the primary predictor and visual memory and visual attention were secondary predictors of two-year FCI change scores. Conclusion Semantic arithmetic knowledge, and to a lesser extent visual memory and attention, are key longitudinal cognitive predictors of financial skill decline in individuals with MCI. Clinical Implications Clinicians should consider neurocognitive abilities of written arithmetic, visual memory, and processing speed in their assessments of financial capacity in person with MCI.

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Section: Introductionmentioning

confidence: 99%

Neurocognitive Predictors of Declining Financial Capacity in Persons with Mild Cognitive Impairment

Niccolai

Triebel

Gerstenecker

et al. 2016

Clinical Gerontologist

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“…For example, patients with impaired performance monitoring can be particularly difficult to rehabilitate (Sherer et al, 2005), as rehabilitation involves learning or re-learning skills, which requires accurate monitoring and appropriate behavioural adaptation in response to errors. In a related way, impairments of self-awareness also contribute to diminished capacity, which is common after TBI Martin et al, 2012). A failure to appreciate ones disability will lead to an impaired ability to make accurate judgements, diminishing patients' capacity .…”

Section: Discussionmentioning

confidence: 99%

1142 The neural basis of impaired self-awareness after traumatic brain injury

Ham

Bonnelle

Hellyer

et al. 2012

J Neurol Neurosurg Psychiatry

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Self-awareness is commonly impaired after traumatic brain injury. This is an important clinical issue as awareness affects longterm outcome and limits attempts at rehabilitation. It can be investigated by studying how patients respond to their errors and monitor their performance on tasks. As awareness is thought to be an emergent property of network activity, we tested the hypothesis that impaired self-awareness is associated with abnormal brain network function. We investigated a group of subjects with traumatic brain injury (n = 63) split into low and high performance-monitoring groups based on their ability to recognize and correct their own errors. Brain network function was assessed using resting-state and event-related functional magnetic resonance imaging. This allowed us to investigate baseline network function, as well as the evoked response of networks to specific events including errors. The low performance-monitoring group underestimated their disability and showed broad attentional deficits. Neural activity within what has been termed the fronto-parietal control network was abnormal in patients with impaired self-awareness. The dorsal anterior cingulate cortex is a key part of this network that is involved in performance-monitoring. This region showed reduced functional connectivity to the rest of the fronto-parietal control network at 'rest'. In addition, the anterior insulae, which are normally tightly linked to the dorsal anterior cingulate cortex, showed increased activity following errors in the impaired group. Interestingly, the traumatic brain injury patient group with normal performance-monitoring showed abnormally high activation of the right middle frontal gyrus, putamen and caudate in response to errors. The impairment of self-awareness was not explained either by the location of focal brain injury, or the amount of traumatic axonal injury as demonstrated by diffusion tensor imaging. The results suggest that impairments of self-awareness after traumatic brain injury result from breakdown of functional interactions between nodes within the fronto-parietal control network.

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“…Retraining visuospatial scanning, attention to visual stimuli [58][59][60] Telling time/analog clock Retraining strengthening of visuospatial information such as clock 71…”

Section: Category Matchingmentioning

confidence: 99%

“…Strengthening non-linguistic cognitive processing and working memory [70][71][72][73][74][75] Quantitative reasoning…”

Section: Category Matchingmentioning

confidence: 99%

Development of an Impairment-Based Individualized Treatment Workflow Using an iPad-Based Software Platform

et al. 2014

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Individuals with language and cognitive deficits following brain damage likely require long-term rehabilitation. Consequently, it is a huge practical problem to provide the continued communication therapy that these individuals require. The present project describes the development of an impairment-based individualized treatment workflow using a software platform called Constant Therapy. This article is organized into two sections. We will first describe the general methods of the treatment workflow for patients involved in this study. There are four steps in this process: (1) the patient's impairment is assessed using standardized tests, (2) the patient is assigned a specific and individualized treatment plan, (3) the patient practices the therapy at home and at the clinic, and (4) the clinician and the patient can analyze the results of the patient's performance remotely and monitor and alter the treatment plan accordingly. The second section provides four case studies that provide a representative sample of participants progressing through their individualized treatment plan. The preliminary results of the patient treatment provide encouraging evidence for the feasibility of a rehabilitation program for individuals with brain damage based on the iPad (Apple Inc., Cupertino, CA). KEYWORDS: iPad, constant therapy, individualized, rehabilitationLearning Outcomes: As a result of this activity, the reader will be able to describe the various cognitive/ language operations involved in specific evidenced-based therapies, and explain the merits/disadvantages of targeted impairment-based rehabilitation for patients with language and cognitive deficits.

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Neurocognitive Predictors of Financial Capacity in Traumatic Brain Injury

Cited by 37 publications

References 24 publications

Neurocognitive Predictors of Declining Financial Capacity in Persons with Mild Cognitive Impairment

Neurocognitive Predictors of Declining Financial Capacity in Persons with Mild Cognitive Impairment

1142 The neural basis of impaired self-awareness after traumatic brain injury

Development of an Impairment-Based Individualized Treatment Workflow Using an iPad-Based Software Platform

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