Neurocognitive Predictors of Financial Capacity in Traumatic Brain Injury

Objective: To develop cognitive models of financial capacity (FC) in patients with traumatic brain injury (TBI). Design: Longitudinal design. Setting: Inpatient brain injury rehabilitation unit. Participants: Twenty healthy controls, and 24 adults with moderate-to-severe TBI were assessed at baseline (30 days postinjury) and 6 months postinjury. Main Outcome Measures: The FC instrument (FCI) and a neuropsychological test battery. Univariate correlation and multiple regression procedures were employed to develop cognitive models of FCI performance in the TBI group, at baseline and 6-month time follow-up. Results: Three cognitive predictor models of FC were developed. At baseline, measures of mental arithmetic/working memory and immediate verbal memory predicted baseline FCI performance (R-2 = 0.72). At 6-month follow-up, measures of executive function and mental arithmetic/working memory predicted 6-month FCI performance (R-2 = 0.79), and a third model found that these 2 measures at baseline predicted 6-month FCI performance (R-2 = 0.71). Conclusions: Multiple cognitive functions are associated with initial impairment and partial recovery of FC in moderate-to-severe TBI patients. In particular, arithmetic, working memory, and executive function skills appear critical to recovery of FC in TBI. The study results represent an initial step toward developing a neurocognitive model of FC in patients with TBI.