All ETDs from UAB

Advisory Committee Chair

Virginia Wadley

Advisory Committee Members

Richard Kennedy

Olivio Clay

Michael Crowe

Cynthia Owsley

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences


Previous research has shown that Mild Cognitive Impairment (MCI) is an intermediary between normal aging and dementia that is associated with declines in financial capacity and driving performance, two important instrumental activities of daily living (IADLs). Both financial capacity and driving performance have been studied cross-sectionally within an MCI population, but there is limited information on the changes in performance over time. The present study utilized data from a recent longitudinal clinical trial of speed of processing training to further examine changes in driving performance and financial capacity over time. Participants included seventy-five older adults with MCI who completed an objective measure of financial ability, the Financial Capacity Instrument – Short Form (FCI-SF), and ninety-eight older adults on a continuum of MCI who underwent standardized on-road driving evaluations. The assessments also included the Trail Making Test- A & B (TMT-A&B), the Useful Field of View (UFOV; subtest 2 used for analyses), informant report of the Functional Assessment Questionnaire (FAQ), and consensus diagnosis. Participants were evaluated at baseline and two annual follow-ups. Repeated measures analyses were conducted to examine changes in clinical diagnosis and iii informant report (FAQ) of driving abilities and financial abilities on objective measures of financial capacity and on-road driving, as well as cognitive predictors of unsatisfactory driving. Results indicate that decline in informant report of financial abilities are associated with decline in the FCI-SF over two years. Additionally, we found that progression within MCI classification and to dementia over two years are associated with significant declines in FCI-SF. We also found that on-road driving performance over two years was associated with decline in informant report of driving, self-report of number of days spent driving per week, and progression in clinical diagnosis. Examination of Time-dependent ROC curve analyses indicated cut points of unsatisfactory driving for the TMT-A, TMT-B, and UFOV-2 including 63 seconds, 196 seconds, and 275 milliseconds, respectively. Overall, findings warrant monitoring of declines in financial abilities and driving performance in an MCI population. The present study contributes to existing knowledge of MCI and dementia by showing the longitudinal changes of the critical IADLs associated with progression of MCI.

Available for download on Sunday, August 25, 2024