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Cognitive Deficit and Mental Capacity Evaluation

Published online by Cambridge University Press:  29 November 2010

Michel Silberfeld
Affiliation:
University of Toronto
Derek Stephens
Affiliation:
Toronto Hospital
Keith O'Rourke
Affiliation:
Toronto Hospital

Abstract

The relationship between the MMSE as a measure of cognitive deficit and two procedures for assessing medical-legal competence is explored. The findings on 60 patients assessed for financial capacity by a multidisciplinary panel, and 41 published cases assessed using the HCAT for capacity to consent to treatment are analysed using logistic regression and ROC curves based on the binary outcome capable/incapable. Cognitive deficit is not a good indicator of the results for mental capacity obtained either by the multidisciplinary panel or the HCAT. The relationship between cognitive deficits and procedures for the allocation of decisional authority is unclear. Some discussion is given to account for this discrepancy.

Résumé

Cette étude examine la relation entre le MMSE comme moyen de mesurer le déficit cognitif et deux méthodes d'évaluation de la compétence médico-légale. Les résultats, qui se fondent sur l'évaluation de 60 patients sur le plan de la capacité financière effectuée par une tribune multidisciplinaire et l'évaluation de 41 cas publiés sur leur capacité de consentement au moyen du HCAT, font l'objet d'une analyse en utilisant une régression logistique et des courbes ROC basées sur les résultats binaires de capacité ou d'incapacité. Le déficit cognitif ne constitue pas un bon indicateur des résultats obtenus sur la capacité mentale tant par la méthode de la tribune multidisciplinaire que celle du HCAT. La relation entre les déficits cognitifs et les méthodes pour l'attribution du pouvoir décisionnel n'est pas claire. Le document discute en partie des raisons de cet écart.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 1994

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