Affiliations: [a] Cognitive Disorders/Dementia Unit, 2nd Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
| [b] Department of Psychology, School of Philosophy, National and Kapodistrian University of Athens, Athens, Greece
| [c] 2nd Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
Correspondence:
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Correspondence to: Sokratis G. Papageorgiou, Associate Professor of Neurology and Neuropsychology, 2nd Department of Neurology, National and Kapodistrian University of Athens, 1 Rimini Str, 12462, Athens, Greece. Tel.: +30 210 5832466; Fax: +30 2105832471; E-mail: [email protected].
Note: [1] These authors contributed equally to this work.
Abstract: Background:In current practice, it is common for the medical practitioner to assess a person’s testamentary capacity (TC) and give evidence to the Courts about a potential will contest. TC is an advanced cognitive activity that is both situation- and task-specific. Objective:The aim of the present study was the development of a brief, specialized instrument for TC assessment in patients with dementia. Method:We developed a short tool consisting of four subtests, assessing the person’s core functions which are required for TC: memory (orientation, autobiographical memory and realistic perception of beneficiaries), absence of serious psychopathology, knowledge of financial parameters (value of assets, everyday life products, bills), and intention (vignettes, theory of mind). For its validation, we examined 64 outpatients from the Cognitive Disorders/Dementia Unit, 2nd Department of Behavioral Neurology, University of Athens. The decision of the expert served as the gold standard for the evaluation of TC. Results:Of the 64 participants, 39 were judged by the expert as capable of TC and the remaining 25 as incapable. For the total scale (maximum score of 48), the best combination of sensitivity (82.6%) and specificity (100%) was obtained for a cut-off score of 32/33. Cronbach’s alpha showed high levels of internal reliability for the scale (α= 0.86) and the point-biserial correlation coefficients showed high levels of criterion-related validity (rbp = 0.797, p < 0.001). Conclusion:The new instrument appears to be a reliable screening tool for the evaluation of TC in dementia, which can be used by both the expert and the non-expert. Further research is needed to confirm these promising findings.
Keywords: Alzheimer’s disease, cognitive dysfunction, dementia, living wills, mental competency, neuropsychological tests, personal autonomy, volition, wills
