Dorien Bangma

102 | CHAPTER 4 Evaluation of FDM tests In total, nineteen different measures of FDM were used in the included studies. One of the most frequently used tests is the FCI (i.e., in 22 of 47 studies; Marson et al., 2000). Furthermore, the conceptual model of Appelbaum & Grisso (1988) is frequently used as a basis of FDM tests, e.g., for the FACT (Black et al., 2007) and ACED (Lai et al., 2008; Lai & Karlawish, 2007). Most tests simulate everyday FDM abilities, such as counting coins or paying bills. Some studies, however, used experimental tests or new scales to assess FDM. Consequently, psychometric properties of these tests are currently unknown. For some tests (i.e., FCI and DAFS) marked differences were observed between studies that used these tests, as different domains were included and total scores were calculated in different ways. With regard to the FCI, various versions have been developed over time, since new domains are introduced and different minimum and maximum scores are calculated for the same FCI domains (e.g., Earnst et al., 2001; Marson et al., 2000; Martin et al., 2019; Martin, Griffith, et al., 2008). This makes a direct comparison between studies that applied the FCI difficult. A major problem that has been identified within the context of assessment of FDM is the lack of accessibility to tests measuring FDMwhich contributes to the development of new FDM tests (Engel et al., 2016). Even though differences in financial systems and procedures between countries sometimes require the development or adjustment of tests, more openness, collaboration and sharing test material is recommended to improve current and future tests focusing on FDM. Furthermore, the ecological validity of FDM tests remains unclear and it can, therefore, not be determined how performances on these tests can be translated to strengths and weaknesses within the context of money management in everyday life. For example, intact performance of people living with relatively mild cognitive disturbances, such as people living with MCI and mild AD, on specific domains of FDM tests suggest the preservation of some FDM skills. Possibly these people can function relatively well in everyday life when performing more basic FDM related actions, such as grocery shopping or paying bills, but need assistance with more complex tasks, such as buying property or taking out (health) insurance(s). Currently it is, however, not possible to formulate clear advice for people living with NDDs and their relatives based on FDM test performances. It also remains unclear whether a deterioration or decline in FDM, as observed in longitudinal studies, results in more everyday life problems. Ceiling effects are frequently found in healthy controls and the actual differences between groups are often very small in terms of scores or points on a test. Therefore, an important focus for further research is the ecological validity of FDM tests. The lack of normative data also complicates the use of performance-based FDM tests in clinical practice. There are also other reasons why the formulation of (legal) decisions about someone’s capacity to manage his or her finances is not possible solely based on performance-based FDM tests. First, it is unclear whether current FDM tests investigate all domains of financial competence. Recently, Engel et al. (2016) described nine domains of financial skills (e.g., basic monetary skills, paying bills, budgeting) and concluded that none of the currently available FDM tests examine all nine domains. Different theoretical models are used and there is major variability in content, type of tasks and administration between tests. More theoretical consensus and the development of more multidimensional FDM instruments, including both