Handwriting as a gauge of cognitive status: a novel forensic tool for posthumous evaluation of testamentary capacity.

OBJECTIVE

To provide an objective way to analyze handwriting, and to test its reliability and correlation with mental deterioration. Handwriting may give clues to the cognitive status of the writer, thus its analysis might be helpful, for example, in the forensic evaluation of a controversial handwritten last will.

DESIGN

We devised a semiquantitative score system taking into account verbal and lexical skills and spatial orientation. We investigated its inter-rater reliability and its correlation with validated tests of neuropsychological status, such the Milan Overall Dementia Assessment (MODA) and the Mini Mental State Examination (MMSE).

SETTING

The neuropsychology service of an academic hospital.

PATIENTS AND

PARTICIPANTS

Consecutive patients referred to the service for evaluation of mental deterioration.

MEASUREMENTS AND

RESULTS

The score system we devised has good inter-rater reliability and significantly correlates with MODA and with MMSE.

CONCLUSIONS

Semiquantitative analysis of handwriting may be a useful addition to the methods available for the posthumous evaluation of testamentary capacity.