Abstract
Clinical assessment of mental competence and capacity in older adults, particularly the capacity to manage one’s financial and legal matters, is an issue of increasing significance within the context of an aging baby boomer population. Together with escalating demands on caregivers, hospitals, and facilities caring for people experiencing cognitive decline, dementia, brain injury and chronic illnesses, and with the increased longevity, changing demographics and societal pressures have triggered debates regarding decisions surrounding wealth transfer via wills and estate planning. Furthermore, these changes parallel the growth of court challenges to legal and medical competence findings, with an enhanced emphasis on ethical and responsible professional practices. With evolving social and economic perspectives on retirement, older adults, from “blue collar” to professional status, now remain longer in employment markets. Thus, we anticipate a higher prevalence of cognitive and associated functional disability both in the workforce and in the general population. In this context, concern emerges regarding vulnerability of persons with cognitive decline to exploitation. With escalating demands for competency assessments, a lack of clear evidence-based guidelines for these evaluations has the potential for significant harm to older adults, their families, and the public. Thus, we define competency and review its relationship with financial and legal capacity and decision-making, neurocognitive functions, and specific functional domains relevant to older adults (e.g., financial management). We then propose a step-by-step model for constructing financial competency assessments for older adults.
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References
Alexopoulos, G. S., Kiosses, D. N., Murphy, C., & Heo, M. (2004). Executive dysfunction, heart disease burden, and remission of geriatric depression. Neuropsychopharmacology, 29(12), 2278–2284. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15340393. https://doi.org/10.1038/sj.npp.1300557.
American Bar Association Commission on Law and Aging, & American Psychological Association. (2008). Assessment of older adults with diminished capacity: A handbook for psychologists. Online.
American Bar Association/American Psychological Association Assessment of Capacity in Older Adults Project Working Group. (2008). Assessment of older adults with diminished capacity: A handbook for psychologists. Online. American Psychological Association.
Billick, S. B., Perez, D. R., & Garakani, A. (2009). A clinical study of competency to consent to hospitalization and treatment in geriatric inpatients. Journal of Forensic Sciences, 54(4), 943–946. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19486444. https://doi.org/10.1111/j.1556-4029.2009.01047.x.
Bisbing, S. B. (1998). Competency and capacity: A primer. In S. S. Sanbar, A. Gibofsky, M. H. Firestone, et al. (Eds.), Legal medicine (4th American College of Legal Medicine ed., pp. 32-43). St. Louis, Mo: Mosby-Year Book.
Black, A. C., Serowik, K. L., Ablondi, K. M., & Rosen, M. I. (2013). Timeline historical review of income and financial transactions: A reliable assessment of personal finances. The Journal of Nervous and Mental Disease, 201(1), 56–59.
Brenkel, M., Whaley, K., Herrmann, N., Crawford, K., Hazan, E., Cardiff, L., & Shulman, K. (2018). A case for the standardized assessment of testamentary capacity. Canadian Geriatrics Journal, 21(1), 26–31. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29581818. https://doi.org/10.5770/cgj.21.283.
Buchanan, A. (2004). Mental capacity, legal competence and consent to treatment. Journal of the Royal Society of Medicine, 97(9), 415–420. https://doi.org/10.1258/jrsm.97.9.415.
Cadar, D., Stephan, B. C., Jagger, C., Johansson, B., Hofer, S. M., Piccinin, A. M., & Muniz-Terrera, G. (2016). The role of cognitive reserve on terminal decline: A cross-cohort analysis from two European studies: OCTO-Twin, Sweden, and Newcastle 85+, UK. International Journal of Geriatric Psychiatry, 31(6), 601–610 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833688/doi:10.1002/gps.4366.
Ciccone, J. R. (2003). Civil competencies. In R. Rosner (Ed.), Principles and practice of forensic psychiatry (2nd ed., pp. 308–315). UK: Hodder Arnold, CRC Press.
Cohen, D., Schultz, I. Z., Sepehry, A. A., & Stewart, A. M. (2019). Assessment of competence in older adults. In R. J. Gatchel, I. Z. Schultz, & C. T. Ray (Eds.), Handbook of rehabilitation in older adults (pp. 433–459). Switzerland AG: Springer.
Cunningham, K. L. (2016). Neuropsychological assessment of medico-legal capacity in the New Zealand context. In J. A. B. Macniven (Ed.), Neuropsychological formulation: A clinical casebook (pp. 89–116). AG Switzerland: Springer International Publishing.
Darba, J., Kaskens, L., & Lacey, L. (2015). Relationship between global severity of patients with Alzheimer’s disease and costs of care in Spain; results from the co-dependence study in Spain. European Journal of Health Economics, 16(8), 895–905. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25348897. https://doi.org/10.1007/s10198-014-0642-0.
de Grey, A. D. (2015). Aging is no longer a “first-world problem”. Rejuvenation Research, 18(6), 495–496. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26684873. https://doi.org/10.1089/rej.2015.1799.
Del Missier, F., Mantyla, T., Hansson, P., Bruine de Bruin, W., Parker, A. M., & Nilsson, L. G. (2013). The multifold relationship between memory and decision making: An individual-differences study. Journal of Experimental Psychology: Learning, Memory, and Cognition, 39(5), 1344–1364. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23565790. https://doi.org/10.1037/a0032379.
Demakis, G. J. (2012). Introduction to basic issues in civil capacities. In G. J. Demakis (Ed.), Civil capacities in clinical neuropsychology: Research findings and practical applications (pp. 3–16). Oxford-New York: Oxford University Press.
Filakovic, P., Eric, A. P., Mihanovic, M., Glavina, T., & Molnar, S. (2011). Dementia and legal competency. Collegium Antropologicum, 35(2), 463–469 Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21755719.
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198 Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/1202204.
Frerichs, R. (2004). When should an older adult be referred to neuropsychology? The Canadian Alzheimer Disease Review, 7(1), 4–9.
Grisso, T. (1986). Evaluating competencies. New York, US: Plenum.
Grisso, T., & Applebaum, P. S. (1998). Assessing competency to consent to treatment: A guide for physicians and other health care professionals (1st ed.). New York-Oxford: Oxford University Press.
Guilmette, T. J., & Krupp, B. H. (1999). The role of mental status measures in civil competency determinations. Journal of Forensic Neuropsychology, 1(3), 1–16. Retrieved from. https://doi.org/10.1300/J151v01n03_01.
He, W., Goodkind, D., & Kowal, P. (2016). An aging world: 2015 (International Population Reports, P95/16-1). Retrieved from https://census.gov/content/dam/Census/library/publications/2016/demo/p95-16-1.pdf:
Hershey, D. A., Austin, J. T., & Gutierrez, H. C. (2015). Financial decision making across the adult life span: Dynamic cognitive capacities and real-world competence. In T. M. Hess, J. Strough, & C. E. Löckenhoff (Eds.), Aging and decision making (pp. 329–349). San Diego: Academic Press.
Hoffman, N. (2018). The assessment of testamentary capacity and undue influence in the older adult. In S. S. Bush & A. L. Heck (Eds.), Forensic geropsychology: Practice essentials (1st ed., pp. 213–234). Washington, DC: American Psychological Association.
Holdnack, J. A., Millis, S., Larabee, G. J., & Iverson, G. L. (2013). Assessing performance validity with the ACS. In J. A. Holdnack, L. W. Drozdick, L. G. Weiss, & G. L. Iverson (Eds.), Practical resources for the mental health professional. WAIS-IV, WMS-IV, and ACS: Advanced clinical interpretation (pp. 331–365). San Diego, CA, US: Elsevier Academic Press.
Holmerova, I., Hort, J., Rusina, R., Wimo, A., & Steffl, M. (2017). Costs of dementia in the Czech Republic. European Journal of Health Economics, 18(8), 979–986. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27785577. https://doi.org/10.1007/s10198-016-0842-x.
Horn, J. L., & Cattell, R. B. (1966). Refinement and test of the theory of fluid and crystallized general intelligences. Journal of Educational Psychology, 57(5), 253–270 Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/5918295.
Jacoby, R., & Steer, P. (2007). How to assess capacity to make a will. BMJ, 335(7611), 155–157. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17641350. https://doi.org/10.1136/bmj.39232.706840.AD.
Juva, K. (2013). Assessment of legal functional capacity of a neuropsychiatric patient. Duodecim, 129(18), 1886–1892 Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24187779.
Kasper, E., Schuster, C., Machts, J., Bittner, D., Vielhaber, S., Benecke, R., & Prudlo, J. (2015). Dysexecutive functioning in ALS patients and its clinical implications. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 16(3-4), 160–171. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25967541. https://doi.org/10.3109/21678421.2015.1026267.
Kershaw, M. M., & Webber, L. S. (2008). Assessment of financial competence. Psychiatry, Psychology and Law, 15(1), 40–55. https://doi.org/10.1080/13218710701873965.
Khin Khin, E., Minor, D., Holloway, A., & Pelleg, A. (2015). Decisional capacity in amyotrophic lateral sclerosis. Journal of the American Academy of Psychiatry and the Law, 43(2), 210–217 Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26071511.
Kirshner, H. S. (2013). Determination of mental competency, a neurological perspective. Current Neurology and Neuroscience Reports, 13(6), 356. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23613011. https://doi.org/10.1007/s11910-013-0356-1.
Kontos, N., Querques, J., & Freudenreich, O. (2015). Capable of more: Some underemphasized aspects of capacity assessment. Psychosomatics, 56(3), 217–226. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25648077. https://doi.org/10.1016/j.psym.2014.11.004.
Kutcher, S., Chehil, S., Cash, C., & Millar, J. (2005). A competencies-based mental health training model for health professionals in low and middle income countries. World Psychiatry, 4(3), 177–180 Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16633545.
Lai, J. M., Gill, T. M., Cooney, L. M., Bradley, E. H., Hawkins, K. A., & Karlawish, J. H. (2008). Everyday decision-making ability in older persons with cognitive impairment. The American Journal of Geriatric Psychiatry, 16(8), 693–696. https://doi.org/10.1097/JGP.0b013e31816c7b54.
Lamberty, G. J., & Nelson, N. W. (2012). Specialty competencies in clinical neuropsychology. New York: Oxford University Press.
Levine, M., & Greer, A. (2013). Legal competency. In F. R. Volkmar (Ed.), Encyclopedia of autism spectrum disorders (pp. 1731–1732). New York, NY: Springer New York.
Lezak, M. D., Howieson, D. B., Bigler, E. D., & Tranel, D. (2012). Neuropsychological assessment (5th ed.). Oxford: Oxford University Press.
Li, S. C., Lindenberger, U., Hommel, B., Aschersleben, G., Prinz, W., & Baltes, P. B. (2004). Transformations in the couplings among intellectual abilities and constituent cognitive processes across the life span. Psychological Science, 15(3), 155–163. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15016286. https://doi.org/10.1111/j.0956-7976.2004.01503003.x.
Li, Y., Baldassi, M., Johnson, E. J., & Weber, E. U. (2013). Complementary cognitive capabilities, economic decision making, and aging. Psychology and Aging, 28(3), 595–613. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24040999. https://doi.org/10.1037/a0034172.
Lichtenberg, P. A., Stoltman, J., Ficker, L. J., Iris, M., & Mast, B. T. (2015). A person-centered approach to financial capacity assessment: Preliminary development of a new rating scale. Clinical Gerontologist, 38, 49–67. https://doi.org/10.1080/07317115.2014.970318.
Lockwood, K. A., Alexopoulos, G. S., & van Gorp, W. G. (2002). Executive dysfunction in geriatric depression. American Journal of Psychiatry, 159(7), 1119–1126. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12091189. https://doi.org/10.1176/appi.ajp.159.7.1119.
Magnus, G. (2015). The age of aging. In G. Magnus (Ed.), The age of aging: How demographics are changing the global economy and our world (1st ed., pp. 33–56). Hoboken, NJ, USA: John Wiley & Sons, Inc..
Marroni, S. P., Radaelli, G., da Silva Filho, I. G., & Portuguez, M. W. (2017). Instruments for evaluating financial management capacity among the elderly: An integrative literature review. Revista Brasileira de Geriatria e Gerontologia, 20, 582–593 Retrieved from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1809-98232017000400582&nrm=iso.
Marson, D. (2016). Conceptual models and guidelines for clinical assessment of financial capacity. Archives of Clinical Neuropsychology, 31(6), 541–553. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27506235. https://doi.org/10.1093/arclin/acw052.
Marson, D. C., Earnst, K. S., Jamil, F., Bartolucci, A., & Harrell, L. E. (2000). Consistency of physicians’ legal standard and personal judgments of competency in patients with Alzheimer’s disease. Journal of the American Geriatrics Society, 48(8), 911–918 Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10968294.
Marson, D. C., Hebert, K., & Solomon, A. C. (2012). Assessing civil competencies in older adults with dementia: Consent capacity, financial capacity, and testamentary capacity. In G. J. Larrabee (Ed.), Forensic neuropsychology: A scientific approach (2nd ed., pp. 401–437). New York: US: Oxford University Press.
Marson, D. C., & Hebert, K. R. (2006). Functional assessment. In D. K. Attix & K. A. Welsh-Bohmer (Eds.), Geriatric neuropsychology: Assessment and intervention (pp. 158–197). New York: The Guilford Press.
Marson, D. C., Huthwaite, J. C., & Hebert, K. (2004). Testamentary capacity and undue influence in the elderly: A jurisprudent therapy perspective. Law and Psychology Review, 28, 71–96.
Marson, D. C., Triebel, K., & Knight, A. (2012). Financial capacity. In G. J. Demakis (Ed.), Civil capacities in clinical neuropsychology: Research findings and practical applications (pp. 39–68). Oxford-New York: Oxford University Press.
Masand, P. S., Bouckoms, A. J., Fischel, S. V., Calabrese, L. V., & Stern, T. A. (1998). A prospective multicenter study of competency evaluations by psychiatric consultation services. Psychosomatics, 39(1), 55–60. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/9538676. https://doi.org/10.1016/S0033-3182(98)71381-7.
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E. M. (2011a). Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology, 77(4), 333. Retrieved from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21788618. https://doi.org/10.1212/01.wnl.0000400650.92875.cf.
McKhann, G. M., Knopman, D. S., Chertkow, H., Hyman, B. T., Jack Jr., C. R., Kawas, C. H., et al. (2011b). The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s & dementia: The Journal of the Alzheimer’s Association, 7(3), 263–269. Retrieved from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21514250. https://doi.org/10.1016/j.jalz.2011.03.005.
McPherson, S., & Koltai, D. (2018). Capacity. In S. McPherson & D. Koltai (Eds.), A practical guide to geriatric neuropsychology (pp. 87–103). Canada: Oxford University press.
Moberg, P. J., & Gibney, M. (2005). Decision-making capacity in the impaired older adult. In S. Bush & T. A. Martin (Eds.), Geriatric neuropsychology: Practice essentials (pp. 491–506). London: Taylor & Francis Group.
Morley, J. E. (2017). Vicissitudes: Retirement with a long post-retirement future. Generations, 41(2), 101–109 Retrieved from https://www.ingentaconnect.com/content/asag/gen/2017/00000041/00000002/art00015.
Morris, R. G., Worsley, C., & Matthews, D. (2000). Neuropsychological assessment in older people: Old principles and new directions. Advances in Psychiatric Treatment, 6(5), 362–370. Retrieved from https://www.cambridge.org/core/article/neuropsychological-assessment-in-older-people-old-principles-and-new-directions/8A7F82B1E191DA8598AB892B4879935D. https://doi.org/10.1192/apt.6.5.362.
Muirhead, P. (2004). When parents and physicians disagree: What is the ethical pathway? Paediatrics & Child Health., 9(2), 85–86 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2720466/.
National Academies of Sciences, Engineering, and Medicine. (2016). In P. S. Appelbaum, C. M. Spicer, & F. R. Valliere (Eds.), Methods and measures for assessing financial competence and performance. Washington, DC: The National Academies Press.
Nikolich-Zugich, J., Goldman, D. P., Cohen, P. R., Cortese, D., Fontana, L., Kennedy, B. K., & Fain, M. J. (2016). Preparing for an aging world: Engaging biogerontologists, geriatricians, and the society. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 71(4), 435–444. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26419976. https://doi.org/10.1093/gerona/glv164.
Pardasani, M. (2018). Motivation to volunteer among senior center participants. Journal of Gerontological Social Work, 61(3), 313–333. https://doi.org/10.1080/01634372.2018.1433259.
Peisah, C., & Shulman, K. I. (2012). Testamentary capacity. In G. J. Demakis (Ed.), Civil capacities in clinical neuropsychology: Research findings and practical applications (pp. 95–120). Oxford-New York: Oxford University Press.
Persad, C. C., Jones, J. L., Ashton-Miller, J. A., Alexander, N. B., & Giordani, B. (2008). Executive function and gait in older adults with cognitive impairment. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 63(12), 1350–1355 Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19126848.
Price, T. (2014). Clinical assessment of financial decision making capacity. In R. M. Factora (Ed.), Aging and money: Reducing risk of financial exploitation and protecting financial resources (pp. 67–74). New York, NY: Springer New York.
Purser, K. J., & Rosenfeld, T. (2014). Evaluation of legal capacity by doctors and lawyers: The need for collaborative assessment. Medical Journal of Australia, 201(8), 483–485 Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25332040.
Richards, T. (2014). When doctors and patients disagree. BMJ, 349, g5567. Retrieved from https://www.bmj.com/content/349/bmj.g5567. https://doi.org/10.1136/bmj.g5567.
Rockwood, K., & Mitnitski, A. (2011). Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clinics in Geriatric Medicine, 27(1), 17–26 Retrieved from https://www.geriatric.theclinics.com/article/S0749-0690(10)00082-0/fulltextdoi:10.1016/j.cger.2010.08.008.
Schultz, I. Z., & Greer, S. (2016). Neuropsychological, psychological, and vocational assessment of high achievers in a medicolegal context. Psychological Injury and Law, 9(2), 154–165. https://doi.org/10.1007/s12207-016-9260-8.
Schultz, I. Z., Sepehry, A. A., & Greer, S. (2018a). Impact of pain on cognitive function in forensic neuropsychology context. Psychological Injury and Law, 11, 129–138. Retrieved from https://link.springer.com/article/10.1007/s12207-018-9318-x. https://doi.org/10.1007/s12207-018-9318-x.
Schultz, I. Z., Sepehry, A. A., & Greer, S. (2018b). Impact of common mental health disorders on cognition: Depression and posttrauamtic stress disorder in forensic neuropsychology context. Psychological Injury and Law, 11, 139–152. Retrieved from https://link.springer.com/article/10.1007/s12207-018-9322-1#citeas. https://doi.org/10.1007/s12207-018-9322-1.
Schultz, I. Z., Sepehry, A. A., & Greer, S. (2018c). Anoxia-hypoxia in forensic neuropsychological assessment: Cognitive impact of pulmonary injuries, respiratory distress, cerebral blood hypoperfusion and major surgeries. Psychological Injury and Law, 11, 153–170. Retrieved from https://link.springer.com/article/10.1007/s12207-018-9319-9. https://doi.org/10.1007/s12207-018-9319-9.
Schwartz, H. I., & Mack, D. D. (2003). Informed consent and competency. In R. Rosner (Ed.), Principles and practice of forensic psychiatry (2nd ed., pp. 97–106). UK: Hodder Arnold, CRC Press.
Shelton, E. G., Orsulic-Jeras, S., Whitlatch, C. J., & Szabo, S. M. (2018). Does it matter if we disagree? The impact of incongruent care preferences on persons with dementia and their care partners. Gerontologist, 58(3), 556–566. Retrieved from https://academic.oup.com/gerontologist/article/58/3/556/2888262. https://doi.org/10.1093/geront/gnw202.
Slick, D. J., Hopp, G., Strauss, E., & Thompson, G. B. (1997). Manual for the Victoria symptom validity test. In Psychological Assessment Resources (PAR). Odessa: FL.
Soliman, S., & Hall, R. C. (2015). Forensic issues in medical evaluation: Competency and end-of-life issues. Advances in Psychosomatic Medicine, 34, 36–48. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25832512. https://doi.org/10.1159/000369083.
Spar, J. E., & Garb, A. S. (1992). Assessing competency to make a will. American Journal of Psychiatry, 149(2), 169–174. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/1482423. https://doi.org/10.1176/ajp.149.2.169.
Strong, M. J., Abrahams, S., Goldstein, L. H., Woolley, S., McLaughlin, P., Snowden, J., & Turner, M. R. (2017). Amyotrophic lateral sclerosis - frontotemporal spectrum disorder (ALS-FTSD): Revised diagnostic criteria. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 18(3-4), 153–174. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28054827. https://doi.org/10.1080/21678421.2016.1267768.
Sullivan, K. (2004). Neuropsychological assessment of mental capacity. Neuropsychology Review, 14(3), 131–142 Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15673234.
Swedish Council on Health Technology, Assessment (2008). SBU systematic reviews. In Dementia—caring, ethics, ethnical and economical aspects: A systematic review. Stockholm: Swedish Council on Health Technology Assessment (SBU). Copyright (c) 2008 by the Swedish Council on Health Technology Assessment.
Tsiouris, J. A., Patti, P. J., & Flory, M. J. (2014). Effects of antidepressants on longevity and dementia onset among adults with Down syndrome: A retrospective study. Journal of Clinical Psychiatry, 75(7), 731–737. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25007424. https://doi.org/10.4088/JCP.13m08562.
Waljee, J. F., Greenfield, L. J., Dimick, J. B., & Birkmeyer, J. D. (2006). Surgeon age and operative mortality in the United States. Annals of Surgery, 244(3), 353–362. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16926561. https://doi.org/10.1097/01.sla.0000234803.11991.6d.
Wechsler, D. (2009). Advanced clinical solutions for the WAIS-IV and WMS-IV. [Measurement instrument]. Bloomington, MN: NCS Pearson, Inc..
Weinstock, R., Leong, G. B., & Silva, A. J. (2003). Competence assessments. In R. Rosner (Ed.), Principles and practice of forensic psychiatry (2nd ed., pp. 85–88). UK: Hodder Arnold, CRC press.
White, M. M., & Lofwall, M. R. (2015). Challenges of the capacity evaluation for the consultation-liaison psychiatrist. Journal of Psychiatric Practice, 21(2), 160–170. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25782767. https://doi.org/10.1097/01.pra.0000462609.10101.2a.
Whiting, D. (2015). Evaluating medico-legal decisional competency criteria. Health Care Analysis, 23(2), 181–196. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23807736. https://doi.org/10.1007/s10728-013-0258-z.
Widera, E., Steenpass, V., Marson, D., & Sudore, R. (2011). Finances in the older patient with cognitive impairment: “He didn’t want me to take over”. Journal of the American Medical Association: JAMA, 305(7), 698–706. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21325186. https://doi.org/10.1001/jama.2011.164.
Wolinsky, F. D., & Johnson, R. J. (1991). The use of health services by older adults. Journal of Gerontology, 46(6), S345–S357 Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/1940101.
Wu, K. C. (2010). Mental capacity of psychiatric patients. Hu Li Za Zhi, 57(6), 5–10 Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21140338.
Xue, Q. L. (2011). The frailty syndrome: Definition and natural history. Clinics in Geriatric Medicine, 27(1), 1–15. Retrived from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3028599/. https://doi.org/10.1016/j.cger.2010.08.009.
Zaloshnja, E., Miller, T., Langlois, J. A., & Selassie, A. W. (2008). Prevalence of long-term disability from traumatic brain injury in the civilian population of the United States, 2005. Journal of Head Trauma Rehabilitation, 23(6), 394–400.Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19033832. https://doi.org/10.1097/01.HTR.0000341435.52004.ac.
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Cohen, D., Sepehry, A.A. & Schultz, I.Z. Forensic Neuropsychological Aspects of Competency Evaluations: Financial and Legal Competency in Older Adults. Psychol. Inj. and Law 13, 19–32 (2020). https://doi.org/10.1007/s12207-019-09364-8
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DOI: https://doi.org/10.1007/s12207-019-09364-8