Finance, Cognition, and Default Network in Aging (FCDNA)

项目摘要/摘要 认知衰退被认为是老年金融剥削的最大风险因素；然而，金融 欺骗认知完好的老年人是有据可查的，而其中的原因却鲜为人知。 我们认为，老年决策失误导致的金融剥削可能是早期功能障碍。 是认知功能减退、轻度认知障碍和阿尔茨海默病的先兆。阿尔茨海默氏症 神经病理学定义为β淀粉样斑块和神经原纤维缠结的堆积，以及网络 被确认为默认网络的内侧额叶、颞叶和顶叶脑区的 易受这种年龄相关的神经病理的影响。后缺省神经网络中的皮质退化 (顶叶和颞叶)发生在阿尔茨海默病的早期，因为这些区域有助于发作性 记忆功能，这些在疾病的早期也会衰退。然而，众所周知，神经病理学 蓄积早期发生在额叶内侧区域，也就是默认网络的前部。虽然 额叶内侧脑区直到病程较晚时才出现结构恶化， 神经病理堆积已被证明影响大脑区域的功能连接，并且 相应地，大脑功能领先于大脑结构。因此，早期的神经病理堆积在 内侧额叶大脑网络可能会影响相关功能，更重要的是，这些内侧额叶网络 对于财务决策来说是不可或缺的。在实践中，临床神经心理评估组合已经 传统上忽视了对内侧额叶大脑网络功能的考虑，尽管在临床前 阿尔茨海默病这些额叶内侧网络功能的改变可能与之一致，甚至先于 明显的情节记忆变化。行为经济偏好测量与时间、风险和 信任是对内侧额叶大脑网络功能特别敏感的工具，以及对这些功能的使用 与常见的神经认知测量方法相结合，可能会提供更敏感和 评估导致阿尔茨海默病的早期大脑变化的综合方法。的总目标是 这项研究旨在研究老年经济剥削与阿尔茨海默病的相关性。 我们假设，由于决策失误而导致的金融剥削经历与更大的 认知能力下降，行为经济偏好的变化更大，提前违约的恶化更大 神经网络(额叶内侧网络)脑功能成像测量与阿尔茨海默病的遗传 风险。鉴于金融危机的原因、背景因素和后果存在显著的异质性 考虑到老年剥削，定性研究的方法将表现为剥削情节 与量化方法相结合，更准确地确定可归因于贫困的开采经验 财务决策，而不是其他原因。调查结果将有助于及早发现并进行干预 这些项目的重点是老年人的认知健康和福祉。

PROJECT SUMMARY/ABSTRACT Cognitive decline is considered the greatest risk factor for financial exploitation in old age; yet, the financial defrauding of cognitively-intact older adults is well-documented, and the reasons for this are poorly understood. We believe that financial exploitation due to poor decision making in old age may be an early functional harbinger of cognitive decline, mild cognitive impairment, and Alzheimer’s Disease. Alzheimer’s Disease is defined neuropathologically by accumulation of beta amyloid plaques and neurofibrillary tangles, and a network of medial frontal, temporal, and parietal brain regions identified as the Default Network is particularly susceptible to this age-associated neuropathology. Cortical deterioration in the posterior Default Network (parietal and temporal lobes) occurs early in Alzheimer’s Disease, and since these regions subserve episodic memory functions, these also decline early in the disease. However, it is also known that neuropathological accumulation occurs early in medial frontal brain regions, the anterior portion of the Default Network. Although medial frontal brain regions do not deteriorate structurally until later in the course of the disease, neuropathological accumulation has been shown to impact functional connectivity of brain regions, and correspondingly brain function, ahead of brain structure. Thus, early neuropathological accumulation in the medial frontal brain networks may impact associated functions, and importantly, these medial frontal networks are integral for financial decision making. In practice, clinical neuropsychological assessment batteries have traditionally neglected consideration of medial frontal brain network functions, despite the fact that in preclinical Alzheimer’s Disease changes in these medial frontal network functions may coincide or even precede noticeable episodic memory changes. Behavioral economic preference measures in relation to time, risk, and trust are tools that appear particularly sensitive to medial frontal brain network functions, and the use of these in combination with common neurocognitive measurement approaches may offer a more sensitive and comprehensive approach to assessing early brain changes leading to Alzheimer’s Disease. The overall goal of this study is to examine the association of financial exploitation in old age with markers of Alzheimer’s Disease. We hypothesize the experience of financial exploitation due to poor decision making is associated with greater cognitive decline, greater change in behavioral economic preferences, greater deterioration in anterior Default Network (medial frontal network) functional brain imaging measures, and greater Alzheimer’s Disease genetic risk. Given significant heterogeneity in the causes, contextual factors, and consequences of financial exploitation in old age to consider, qualitative research approaches to phenotype exploitation episodes will be integrated with quantitative methods to more accurately identify exploitation experiences attributable to poor financial decision making as opposed to other reasons. Findings will inform early detection and intervention programs focused on cognitive health and wellbeing in old age.