F27 Factors that influence financial vulnerability in huntington’s disease

Abstract

Advances in technology have changed the way in which we spend and manage our money. For most people this has been a liberating development but for the thousands of people living with dementia this poses serious challenges to their ability to live independently and puts them at increased risk of financial abuse. A loss of financial autonomy and monetary mismanagement is a characteristic feature of Huntington’s disease (HD), however, it is currently unclear what drives these problems. We know that patients experience disruption to the functional integrity of the frontostriatal circuitry leading to a characteristic dysexecutive syndrome that can be accompanied by behavioral problems such as impulsivity, poor risk assessment and emotional changes. There is also evidence that they can struggle to interact socially, but the extent to which these problems relate to their financial vulnerability is unknown. In this study we adopted both theory and methodology from the field of social economics to help provide an insight into the reasons why patients with HD are vulnerable to financial abuse. The results indicate that patient’s generosity on social economics tests such as the Dictator, Ultimatum, Trust and Public Goods Games increases with advancing HD whilst their ability to adjust their risk taking behavior in the context of relevant information deteriorates. Furthermore, performance strongly correlated with their ability to accurately interpret the feelings and beliefs of their confederates. This suggests that both an increased tendency to make risky decisions and difficulty identifying spurious financial offers or disingenuous people may be important factors that promote HD patient’s susceptibility to financial abuse.