Managing Money Difficult for MS Patients with Cognitive Problems and Depression, Study Says
Effective money management, critical to independent living, is particularly difficult for people whose multiple sclerosis (MS) affects executive thinking skills and who struggle with depression and anxiety, a study reports.
The study, “Money Management in Multiple Sclerosis: The Role of Cognitive, Motor, and Affective Factors,” was published in the journal Frontiers in Neurology.
Money management refers to such essential everyday talks as managing cash flow, banking, paying bills, and budgeting — essential parts of life and social participation.
Previous research found that MS patients struggle at managing their finances compared to people without this disease, because it impacts cognitive abilities related to financial management, like working memory and executive function (the ability to plan and coordinate an action).
A rehabilitation research team at the Kessler Foundation looked more closely at the motor, cognitive, and emotional factors involved with effective money management among people with MS, by comparing a group of patients who did these tasks well to a group who did not, and both to a group of gender- and age-matched healthy people serving as controls.
In total, this study looked at 72 people with MS, ages 18 to 65, and 26 controls.
Money management skills were assessed using two methods: a money management questionnaire developed for people with brain injury, and the KF-Actual Reality, a performance-based tool developed at Kessler that tests five behaviors essential to money management via a person making an online purchase.
Based on performances on these two tests, 34 patients were categorized as efficient money managers (MS efficient-MM), and 38 as inefficient money managers (MS inefficient-MM).
“The MS inefficient-MM group reported problems … included using an ATM, paying the rent or bills late, owing money, spending all their money within the first few days of receiving it, going without essentials such as food because they had run out of money, impulse buying, and spending money on things they do not really need,” the researchers wrote.
Controls performed at each money management assessment than either MS group.
Likewise, those patients who were groups as inefficient money managers performed worse on basic tests of cognitive skills, including verbal memory, executive function, and processing speed, compared to both healthy controls and “efficient” MS patients.
Cognitive scores for the 34 people with MS who were seen to be good at managing their finances were similar to people without this disease.
Control participants and MS patients with efficient money skills were also less likely to report symptoms of anxiety or feelings of depression than the “inefficient” MS group based responses to two questionnaires, the Chicago Multi-scale Depression Inventory and the State and Trait Anxiety Inventory.
Overall, patients with evidence of better executive functioning skills and lesser feelings of anxiety and depression were more likely to handle money well, implying a better quality of life.
“During money management performance, problems in making appropriate choices related to price, choosing the most appropriate items and reviewing prices were observed. … These problems can also lead to significant economic and safety consequences for patients and significant stress and burden for caregivers,” the researchers said.
They suggested that “practitioners working with persons with MS should be aware that executive function impairments together with depressive symptomatology could signal possible money management dysfunction.”
Study findings of difficulties with money management pertained only to “a subset” of MS patients, the study’s lead author, Yael Goverover, PhD, said in a press release, and do not and should not characterize “the MS population as a whole.”
Goverover also noted that the association between money management difficulties and depressive symptomatology is a new finding, and further research is warranted.
“Difficulties with managing money can have serious financial, legal, and psychological consequences for individuals and their caregivers,” Goverover said.
“Owing money, paying bills late … these behaviors adversely affect the ability to function independently in everyday life. Knowing the factors that underlie money management problems will enable providers to identify those at risk and counsel caregivers to intervene effectively to minimize negative behaviors,” she added.