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Home > Testamentary Capacity Assessment Tool (TCAT): A Brief Instrument for Patients with Dementia.

TitleTestamentary Capacity Assessment Tool (TCAT): A Brief Instrument for Patients with Dementia.
Publication TypeJournal Article
Year of Publication2018
AuthorsPapageorgiou, SG, Voskou, P, Economou, A, Beratis, I, Douzenis, A
JournalJ Alzheimers Dis
Volume61
Issue3
Pagination985-994
Date Published2018
ISSN1875-8908
KeywordsAdult, Aged, Cognition Disorders, Dementia, Female, Humans, Male, Memory, Mental Competency, Middle Aged, Neuropsychological Tests, Reproducibility of Results, Sensitivity and Specificity, Wills
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 

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.

DOI10.3233/JAD-170297
Alternate JournalJ. Alzheimers Dis.
PubMed ID29254082
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