The Testamentary Capacity Assessment Tool (TCAT): validation and normative data.

Abstract

There is an increasing need for objective and standardized assessment of testamentary capacity (TC) in dementia. A new instrument, the Testamentary Capacity Assessment Tool (TCAT), has been recently developed; however, the lack of validation and normative data regarding this cognitive screening test has limited its adoption in forensic and clinical settings. The present study collects normative data for the TCAT and assesses its convergent validity with standardized cognitive tests and the capacity to define what a 'testament' is. The study involved 323 neurologically healthy adults (123 males, 200 females) of different ages (31-93years) and different educational levels (4-25years). The TCAT was administered along with the Beck Depression Inventory-II (BDI-II), the Montreal Cognitive Assessment (MoCA), theMini-Mental State Examination (MMSE), theFrontal Assessment Battery (FAB) and the Testament Definition Scale (TDS). Multiple regression analyses revealed a significant effect for gender, age and education on TCAT scores. Correlation analyses showed significant associations between the TCAT and the MMSE, MoCA, FAB and BDI-II. A positive correlation between the TCAT and TDS was also found, proving good convergent validity of the TCAT with respect to TC. Finally, cut-off scores and Equivalent Scores (ES) were computed. The present study provides normative data for using the TCAT as anadjuvant cognitive screening test in the neuropsychological evaluation of TC. Our findings shall be of interest for theadoption of the TCAT alsoin clinical practice, since it evaluates cognitive functions (e.g., autobiographic memory, Theory of Mind) not measured by traditional screening tests.