REVIEW   

Minerva Psichiatrica 2020 June;61(2):35-46

DOI: 10.23736/S0391-1772.19.02040-5

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Decision making in mild cognitive impairment: medicolegal implications

Raffaella RINALDI ¹ ✉, Gianluca MONTANARI VERGALLO ¹, Giuseppe BERSANI ², Letizia CARADONNA ³

¹ Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University, Rome, Italy; ² Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy; ³ Direzione Sanità RFI, Gruppo FSI, Turin, Italy

INTRODUCTION: Mild cognitive impairment (MCI) is a clinical entity identified in 1980s, considered as an intermediate stage between normal ageing and dementia, which is characterized by a cognitive decline more severe than expected in normal ageing. Although the scientific community has shown interest in MCI, the forensic implications of MCI have been poorly investigated. Forensic implications are huge, affecting all aspects of the so-called ability to act. Health care professionals, and, more often, forensic experts, have to discriminate if MCI patients sufficiently perform in different actions with important legal relapses. But the question is: are there means or parameters you may use in order to decide about MCI subjects’ competence? The primary aim of the article was to describe the state of the art providing a systematic review of the scientific literature on decision-making capacity.
EVIDENCE ACQUISITION: This is the first research that provides a systematic review on the field, focusing exclusively on MCI patients.
EVIDENCE SYNTHESIS: This review highlights lack of uniformity in methods of judgment and in their interpretation about MCI competency, as well as showing the absence of papers about some key areas such as the testamentary capacity.
CONCLUSIONS: MCI seems to affect deeply decision-making capacity, causing social, personal and family problems, at different levels.

KEY WORDS: Cognitive dysfunction; Decision making; Psychiatry; Forensic medicine