Introduction
The capacity to manage financial affairs is a multidimensional construct and includes a wide range of judgment, perceptual, and pragmatic activities, ranging from the most basic abilities to higher levels of abilities. With aging, some cognitive functions such as memory, attention, judgment, and managing financial affairs are affected. The decline of cognitive abilities and financial capacity in the elderly can cause problems for them, their families, and society. Due to the fact that so far, no any questionnaire in accordance with the social and cultural conditions of Iranian society has been designed to measure the financial capacity of the elderly, the present study aims to design and develop a tool for measuring the financial capacity of Iranian elderly.

Methods
This study was conducted in four steps using Waltz’s strategy:
● Defining objectives: Identifying the available tools for measuring financial capacity (by information retrieval, combining evidence, interpreting clinical research, evaluating different areas of the tool) and designing the tool through a collaborative process and consensus;
● Selecting a conceptual model: The tools for measuring the financial capacity were found based on a literature search, their contents were analyzed, and the related concepts were extracted;
● Blueprinting: The initial draft of the tool, including main and secondary areas (Table 1), was prepared, and the relevant questions were formulated according to the opinion of experts.


● Construction: It includes the use of procedures, item sets, and scoring rules to construct the measure. 
To check and determine the validity of the tool, its face validity and content validity were evaluated. A content validity ratio (CVR) with a value of 0.56 was considered as the critical point and the necessity of the item, and a CVI >0.7 was considered as a measure of the simplicity, relevance, and clarity of the items.

Results
In the first step, 15 studies were found that had used 11 tools for measuring financial capacity. Instruments had been published from 1996 to 2015. There was a web-based instrument called the financial capability scale- short form (FCI-SF) designed in 2022. All instruments covered different domains of financial capacity, except for one instrument that focused on more limited domains (psychological issues). The instruments were for different target groups, but mainly for healthy and cognitively impaired older people.
In the second step, the initial draft, including 9 main areas, 27 sub-areas, and 158 items (2-3 items in each sub-area), was prepared. The items in this questionnaire cover the following areas:
● The history of having financial responsibilities, the problems and difficulty performing financial tasks, the way of making financial decisions and judgments according to the social and cultural conditions, as well as environmental support and limitations;
● Cognitive assessment with emphasis on declarative memory and executive processes of judgment, planning, and reasoning;
● Psychological assessment to determine the effective role of psychological symptoms in managing financial affairs;
● Performance-based assessment of financial capacities;
● Assessing the vulnerability to fraud and financial abuse.
The values of CVR for 34 items were >0.56. The number of accepted items with a CVI >0.7 was 57 items. For 8 items, the CVI was <0.7. Finally, 68 items were reduced to 65 items. In addition, based on the opinions of the target group and the panel of experts during the qualitative content validity determination, the items were revised and the necessary corrections were made on them. The CVR and CVI for the overall scale were 0.57 and 0.83, respectively. By developing guidelines for each item, acceptable or unacceptable answers and scoring method were determined.

Conclusion
With a broader assessment approach and due to its semi-structured nature and accompanying instructions, the designed tool can help clinicians in Iran to more accurately find older people who are no longer able to manage their financial affairs. Also, this tool can help categorize the levels of financial capacities in an older person. This study was a pilot study, and the inter-rater reliability, test re-test reliability, and construct validity of the tool were not evaluated. In future studies, it is recommended to prepare a short version of this tool for quick and easier use in clinical practice. By determining the relationship of the score of this tool with the level of education, cognitive level, or other involved criteria, a cut-off point can be determined for this tool.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of Iran University of Medical Sciences (Code: IR.IUMS.FMD.REC.1400.172).

Funding
This article is extracted from the PhD dissertation of Razieh Bakhshande, approved by Department of Psychiatry, School of Medicine, Iran University of Medical Sciences.

Authors' contributions
Conceptualization: Behnam Shariati and Vahid Rashedi; Methodology, investigation, funding acquisition and resources: All author; Writing the original draft: Vahid Rashedi, Behnam Shariati and Razieh Bakhshandeh; Review & editing: Vahid Rashedi, Behnam Shariati and Razieh Bakhshandeh; Supervision: Behnam Shariati, Vahid Rashedi.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
The authors express their gratitude for the cooperation of respected experts: Kaveh Alavi, Seyed Vahid Shariat, Hamid Yousefi, Leila Sadiq Moghadam, Marjan Haghi, Mahshid Foroughan, Pooya Farrokhnejad Afshar, Majid Rahimi, Maryam Nik Solat and Seyed Mehdi Saberi" for designing and preparing the preliminary psychometrics of this tool.

 

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