title: Legal medical consideration of Alzheimer's disease patients' dysgraphia and cognitive dysfunction: a 6 month follow up.
abstract: BACKGROUND
  The purpose of this study was to investigate the ability of Alzheimer's disease (AD) patients to express intentions and desires, and their decision-making capacity. This study examines the findings from a 6-month follow-up of our previous results in which 30 patients participated.
  
  
  METHODS
  The patient's cognition was examined by conducting the tests of 14 questions and letter-writing ability over a period of 19 days, and it was repeated after 6 months. The difference between these two cognitive measures (PQ1 before-PQ2 before), tested previously and later the writing test, was designated DΔ before. The test was repeated after 6 months, and PQ1 after-PQ2 after was designated DΔ after.
  
  
  RESULTS
  Several markedly strong relationships between dysgraphia and other measures of cognitive performance in AD patients were observed. The most aged patients (over 86 years), despite less frequency, maintain the cognitive capacity manifested in the graphic expressions. A document, written by an AD patient presents an honest expression of the patient's intention if that document is legible, clear, and comprehensive.
  
  
  CONCLUSIONS
  The identification of impairment/deficits in writing and cognition during different phases of AD may facilitate the understanding of disease progression and identify the occasions during which the patient may be considered sufficiently lucid to make decisions.
authors.affiliation: Department of Anatomy, Histology, Legal Medicine and Orthopaedics, Sapienza University of Rome, Rome, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Onofri
authors.affiliation: Department of Anatomy, Histology, Legal Medicine and Orthopaedics, Sapienza University of Rome, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Mercuri
authors.affiliation: Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Trevor
authors.initials: T
authors.lastname: Archer
authors.affiliation: Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Max
authors.initials: M
authors.lastname: Rapp-Ricciardi
authors.affiliation: Department of Anatomy, Histology, Legal Medicine and Orthopaedics, Sapienza University of Rome, Rome, Italy.
authors.forename: Serafino
authors.initials: S
authors.lastname: Ricci
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000381:Agraphia / Q000175:diagnosis*; D000544:Alzheimer Disease / Q000523:psychology*; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis*; D003657:Decision Making; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033182:Intention; D008297:Male; D016743:Mental Competency / Q000331:legislation & jurisprudence*; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires
keywords: cognition; consent; intentions; unfit to plead