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Evaluating voting competence in persons with Alzheimer disease
Pietro Tiraboschi1, Erica Chitò, Leonardo Sacco
1Fondazione Europea Ricerca Biomedica (FERB), Centro Alzheimer, Ospedale Briolini, Gazzaniga, Bergamo, Italy.
International Journal of Alzheimer'S Disease
|July 26, 2011
Summary
Assessing voting capacity in individuals with Alzheimer's disease (AD) is crucial. The adapted Competence Assessment Tool for Voting (CAT-V) shows that while understanding and reasoning decline, the ability to express a choice remains largely intact.
Area of Science:
- Neuroscience
- Gerontology
- Legal Medicine
Background:
- Assessing decision-making capacity in individuals with dementia, particularly concerning voting, presents significant challenges.
- Existing methods for evaluating voting capacity, such as the US Competence Assessment Tool for Voting (CAT-V), have not been widely tested internationally.
Purpose of the Study:
- To translate and adapt the US Competence Assessment Tool for Voting (CAT-V) for the Italian context.
- To evaluate the voting capacity of individuals with Alzheimer's disease (AD) using the adapted CAT-V.
- To examine the relationship between dementia severity and performance on the CAT-V.
Main Methods:
- The study involved translating and culturally adapting the CAT-V for use in Italy.
- The adapted CAT-V was administered to 38 participants with Alzheimer's disease (AD) prior to the 2006 Italian Prime Minister elections.
- The CAT-V assesses three key decision-making abilities: understanding the nature and effect of voting, expressing a choice, and reasoning about voting choices.
- Performance on the CAT-V was analyzed in relation to dementia severity, with Mini-Mental State Examination (MMSE) scores also recorded.
Main Results:
- Only 3 out of 38 participants with AD achieved maximum scores on all CAT-V items.
- There was a moderate correlation (r = 0.59; P < 0.0001) between MMSE and CAT-V scores, indicating variability in performance across dementia stages.
- A significant majority (90%) of participants scored maximum points on the 'expressing a choice' component, despite poorer performance on understanding and reasoning items.
Conclusions:
- Mini-Mental State Examination (MMSE) scores provide only a rough prediction of voting capacity in individuals with Alzheimer's disease (AD).
- A structured assessment tool like the adapted Competence Assessment Tool for Voting (CAT-V) may offer a more accurate measure of voting capacity.
- The ability to express a choice appears to be the least affected decision-making domain by the progression of dementia in AD patients.
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