Effects of severity of dementia on a symptom validity measure

While prior research has shown symptom validity tests (SVTs) to have clinical utility with cognitively impaired individuals, these studies typically excluded those diagnosed with mild cognitive impairment (MCI) and dementia. The purpose of this study was to determine the utility of an SVT, the Test of Memory Malingering (TOMM), in those with MCI and moderate to severe dementia. Participants included 30 cognitively intact individuals (Control Group), 28 diagnosed with MCI (MCI Group), and 31 diagnosed with moderate to severe dementia (Moderate-Severe Group). The range of Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Total Standard Scores were then calculated for each group and all participants were administered the TOMM. Analysis of covariance (ANCOVA) revealed no significant differences on TOMM Trail 2 scores between the Control Group and the MCI Group. While all group means were above established cut-off scores, approximately 20% of participants in the Moderate-Severe Group failed the TOMM according to established criteria. Results suggest that the TOMM may be an appropriate test of effort in older adults diagnosed with MCI, but is not recommended for assessing potential malingering in those with at least moderate to severe dementia.