Objective: The present study reviews all studies about TCAT and its use in clinical settings, as well as its validation in different cultures.

Background: TCAT is a recently developed, short instrument (15 minutes required for its administration), with good psychometric properties, specialized for the assessment of testamentary capacity (TC) in dementia. It assesses memory, perception of financial parameters and judgment. It evaluates cognitive functions not measured by other traditional tools, such as social cognition and it does not require the use of collateral information regarding financial parameters.

Method: Pubmed database as well as unpublished data have been used.

Results: For now, there are no other specialized TC assessment instruments with measured psychometric properties in the scientific literature. Unpublished data about amnestic mild cognitive impairment (aMCI) performance in TCAT shows no difference of aMCI in comparison to healthy adults at any part of the tool. Another unpublished data has studied the correlation between the three parts of TCAT and the expert opinion regarding TC in patients with dementia. It has concluded that the Part C of financial parameters demonstrates the highest relevance with the expert opinion. Validation and standardization of the TCAT in Greek population is under study. The preliminary results show that age, and not educational level or gender, may predict the performance in TCAT. Validation and normative data of the TCAT in an Italian population of 323 healthy adults is provided in a recent published study showing that it is useful as an adjuvant instrument for TC assessment in the elderly.

Conclusion: While TCAT is a useful tool, more studies are needed to be held in different cultures, both in healthy adults and cognitively impaired adults, for its standardized use in forensic and clinical settings.

References: – Testamentary Capacity Assessment Tool (TCAT): A Brief Instrument for Patients with Dementia. Papageorgiou SG*, Voskou P*, Economou A, Beratis I, Douzenis A. J Alzheimers Dis. 2018;61(3):985-994. doi: 10.3233/JAD-170297. (* Equal contribution to this paper).
– Testamentary Capacity Assessment: Legal, Medical, and Neuropsychological Issues. Voskou P, Douzenis A, Economou A, Papageorgiou SG. J Geriatr Psychiatry Neurol. 2018 Jan;31(1):3-12. doi: 10.1177/0891988717746508.
– The Testamentary Capacity Assessment Tool (TCAT): validation and normative data. Bolognini N, Gramegna C, Esposito A, Aiello EN, Difonzo T, Zago S. Neurol Sci. 2021 Nov 17. doi: 10.1007/s10072-021-05736-8. Online ahead of print. PMID: 34787752

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