Encyclopedia of Psychology and Law

(FCI-8). New domains assessed bill payment (D7) and

knowledge of personal assets and estate arrangements

(D8). An index of overall financial capacity was also

introduced. The FCI was last modified in 2003 (FCI-9).

Tasks pertaining to the detection and avoidance of

telephone and mail fraud remained under the domain

of financial judgment (D6). Investment decision mak-

ing, which was included as part of D6 in earlier ver-

sions of the FCI, was accorded its own domain (D9).

Administration and Scoring of the FCI

Financial abilities and experience can vary substan-

tially across individuals. It is important to identify an

individual’s prior level of financial skill and experience

before administering the FCI or any other financial

capacity instrument. For example, it would be mislead-

ing to test for checkbook management skills in a person

who has never used a checkbook. An instrument

for assessing prior financial experience is the Prior

Financial Capacity Form. This rating form is completed

by both patients and informants and assesses whether

an individual could previously perform designated

financial tasks and activities (a) independently, (b) only

with assistance, or (c) not even with assistance.

FCI tasks are administered serially by domain. A

system of prompts and recognition format questions is

included to allow partial credit for persons with amne-

sia or aphasia.

Task-, domain-, and global-level performance scores

are obtained using a detailed and standardized scoring

system. Performance scores for each domain are

obtained by summing task scores within that domain.

Performance scores at the global level (overall financial

capacity) are obtained by summing domain scores.

FCI performance scores can also be converted into

capacity outcomes (capable, marginally capable, or

incapable) using psychometric cut scores derived from

normal control performance. These capacity outcomes

are to be interpreted cautiously, as they are based on

psychometric cut scores and are not equivalent to clin-

ically or legally determined capacity judgments. However,

the outcomes serve as a useful additional perspective

for understanding performance on the FCI.

Reliability and Validity of the FCI

The original FCI-6 demonstrated adequate to excel-

lent internal, test-retest, and inter-rater reliabilities at

task and domain levels using small samples of older

adult controls and AD patients. Very good to excellent

reliabilities were obtained for the FCI-8 at the domain

level. At the task level, the FCI-8 demonstrated excel-

lent inter-rater reliability but mixed internal and

test-retest reliability. This probably reflected item

reductions within tasks and reduced task range.

All versions of the FCI arguably have strong face

and content validity. The FCI tasks and domains rep-

resent simple and complex financial abilities and

activities that are commonly performed by older

adults in the community. The FCI structure and con-

tents were reviewed and approved by a panel of

physicians, gerontologists, an attorney, and a judge

with considerable knowledge of the financial capac-

ity construct.

The FCI has also demonstrated construct validity.

FCI domains and tasks have been found to discrimi-

nate well the performance of cognitively intact older

adults from that of patients with mild to moderate AD

and patients with amnestic MCI. In addition, impaired

domain-level performance in MCI and AD has been

correlated with deficits in cognitive functions of

semantic memory, working memory, simple attention,

and executive function. In the continuing absence of a

clear criterion measure for assessing financial capac-

ity, this research provides initial support for the con-

struct validity of the FCI.

Future Research

Preliminary research on the reliability and validity of

the FCI is promising. Its direct, standardized, and

quantified approach to assessing financial abilities

and activities represents a new and significant contri-

bution to the area of functional capacity assessment.

However, initial studies using the FCI have been lim-

ited to relatively small samples of cognitively intact

older adults and persons with MCI and AD. No

research has been conducted to date that examines

financial performance among other populations, such

as persons with serious mental illness. Therefore,

studies with larger and more heterogeneous control

and clinical samples are needed. Future validation

studies should compare FCI results with the judgment

of experienced clinicians based on clinical interviews.

Daniel C. Marson and Katina R. Hebert

See alsoCompetency, Foundational and Decisional;

Financial Capacity; Forensic Assessment; Guardianship

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