Cognitive Toll of MS Can Include Ability to Handle Personal Finances, Study Finds

People with multiple sclerosis, especially those with cognitive disabilities, have more problems managing their personal finances — paying bills on time or using a credit card — than those without this disease, researchers report in the study, “Money Management Activities in Persons With Multiple Sclerosis,” published in the journal Archives of Physical Medicine and Rehabilitation.

MS, an autoimmune disease of the central nervous system, is typically associated with physical impairments but can also have a significant impact on cognitive abilities.  More than 50% of MS patients exhibit difficulties in learning and memory, attention, information processing speed, executive functions (also known as cognitive control, the set of mental tools that enable us to plan, focus our attention, and remember instructions), and in visuospatial skills (needed to perceive objects and the spatial relationships among them).

A crucial skill in everyday life and to independent living is the ability to manage one’s own finances. Money management is a complex task, needing both solid attention and speed-processing skills, and can be particularly difficult people with the cognitive impairments associated with MS.

Researchers set out to investigate two questions: whether individuals with MS experience more problems in managing finances compared with those without MS, and what conditions may contribute to these difficulties.

To this end, the team performed a cross-sectional study
 (a type of observational study that analyzes and compares data collected from a population, or a representative subset, at one time point or over a short period of time) with MS patients recruited at a nonprofit rehabilitation research institution; as controls, researchers recruited persons without MS from the community.

In total, the study included 30 MS adult patients and 23 healthy controls. Participants underwent several neuropsychological tests, including tests for learning and memory, executive functions, processing speed and working memory, and depression and anxiety; a money management survey; and a functional test to assess money management skills.

Results showed that, indeed, MS patients reported more problems in managing money, and showed greater levels of difficulty in handling actual money management tasks when compared to control individuals. Importantly, and in agreement with the researchers’ hypothesis, MS patients reported (on the survey) significant problems managing their finances: forgetting bills to paid and, as a consequence, being faced with debts, and needing to borrow money or use an automatic teller machine.

With performance-based money management tasks, MS patients had a significant higher rate of errors when compared to controls, showing significantly more credit card errors and taking considerably more time to complete a task (purchasing cookies over the internet).

Moreover, researchers observed that money management errors were significantly associated with all cognitive measure scores, with MS patients showing slower processing, memory impairments, and impaired executive functions. Finally, the team also observed that patients’ self-reported functional status significantly correlated with their self-reported money management skills.

Overall, results showed that patients with MS exhibit significant problems in money management, a crucial activity of daily living. Researchers highlight that this is the first study examining money management skills and MS, and that these results support the use of practical, real-world tasks to assess cognitive function and to promote rehabilitation.