Exploring the predictors of financial impairment in Huntington's disease using the Enroll-HD dataset.


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Authors
Harris, Kate L 
Mason, Sarah L 
Barker, Roger A 
Abstract

OBJECTIVES: Huntington's disease (HD) is a neurodegenerative disease in which cognitive and behavioural symptoms impair the performance of instrumental activities of daily living, including the handling of finances. We sought to determine the prevalence of financial dysfunction in HD, and the demographic and clinical predictors of such impairments. METHODS: We analysed longitudinal data for pre-manifest gene carriers and HD patients from the Enroll-HD dataset. Financial dysfunction was determined by finance-related items in the Total Functional Capacity (TFC) and Functional Assessment (FA) scales. A binary logistical regression model was used to investigate the predictive value of demographic and clinical factors for the development of financial dysfunction. RESULTS: Financial impairment was found to be common in HD gene carriers, and over half required financial assistance within 5 years from diagnosis. Cognitive impairment, apathy, unemployment and disease severity predicted financial dysfunction in manifest patients. For pre-manifest patients, the predictors were proximity to disease onset and depression. CONCLUSIONS: Loss of financial autonomy is common in HD, and cognitive and psychiatric factors are important in its development. Clinicians must be vigilant to identify patients that may be vulnerable to financial exploitation.

Description
Keywords
Apathy, Cognitive impairments, Financial impairments, Huntington’s disease, Neurodegeneration, Activities of Daily Living, Apathy, Cognitive Dysfunction, Humans, Huntington Disease, Neurodegenerative Diseases
Journal Title
J Neurol
Conference Name
Journal ISSN
0340-5354
1432-1459
Volume Title
269
Publisher
Springer Science and Business Media LLC
Sponsorship
National Institute for Health and Care Research (IS-BRC-1215-20014)
Medical Research Council (MC_PC_17230)