State-of-the-Art Testamentary Capacity Assessment Tool (TCAT) in Dementia: A Review of Studies and Update Report

Background: The TCAT (Testamentary Capacity Assessment Tool) is a short instrument 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, such as social cognition, not measured by other traditional tools, while collateral sources of information regarding financial parameters are not needed. The present study is a review including all the relevant studies both for TCAT’s use in clinical settings and its validation in different cultures. Methods: Pubmed database has been used. Results: At the present, there are no other specialized screening TC assessment instruments with measured psychometric properties in the scientific literature. The TCAT has been validated in healthy Italian population and is highlighted that it is useful as an adjuvant instrument for TC assessment in the elderly. It is clinically useful in acute ischemic stroke, while its strengths are emphasized in a systematic review of the existing TC assessment instruments. Conclusions: TCAT is a useful screening specialized tool, easily applicable in clinical practice both from experts and non-experts. More studies are recommended to be held in different cultures, both in healthy and cognitively impaired adults, for its standardized use in forensic and clinical settings.