Persons with Alzheimer's disease (AD) demonstrate frank impairments in the performance of everyday functional abilities. However, the neuroanatomic and neuro-metabolic correlates of these functional deficits in mild AD are largely unknown. Using 3-Tesla proton magnetic resonance spectroscopy (1H-MRS) of the posterior cingulate gyrus in 14 patients with mild AD and 14 healthy adult controls, we sought to determine the brain metabolic correlates of financial impairments in mild AD. Both N-acetylaspartate (NAA) and choline-containing compounds (Cho) were found to be abnormal in mild AD. In AD patients, NAA showed a positive correlation with financial abilities, while Cho showed a possible negative correlation with financial abilities. These findings suggest that metabolic abnormalities of posterior cortical paralimbic regions may reflect the underlying neuropathological processes that are instrumental in the degradation of financial abilities in mild AD. Proton MRS could offer a means to track brain changes associated with functional change in mild AD. © Springer Science + Business Media, LLC 2007.