Coin in the Hand Test for detection of malingering memory impairment in comparison with mild cognitive impairment and mild dementia in Alzheimer‘s disease

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Authors: A. Bartoš ^1–3; M. Raisová ^1–3
Authors place of work: Neurologická klinika a Klinika psychiatrie a lékařské psychologie, 3. LF UK, Praha ¹; Neurologická klinika a Oddělení klinické psychologie, FN Královské Vinohrady, Praha ²; Národní ústav duševního zdraví, Klecany ³
Published in the journal: Cesk Slov Neurol N 2019; 82(3): 316-321
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2019316

Summary

Aim: The Coin in the Hand Test (CHT) can be used to measure memory deficit malingering. The aim of the study was to find out which results are achieved by individuals without cognitive deficits or persons pretending to have cognitive impairment compared to patients with real cognitive deficits.

Patients and methods: CHT is a short screening tool for detecting memory deficit malingering. The task is to memorize in which hand the examiner held a coin during 10 trials. One point is given for every correct determination of the side. The total range is from zero to ten points. Four groups were examined: 1. 112 seniors with normal scores on the Montreal Cognitive Assessment (MoCA; 28 ± 1 point) and in the animal verbal fluency test (27 ± 5 points); 2. 33 elderly individuals who were asked for intentional memory deficit malingering in TMR and had normal score (MoCA = 28 ± 2 points); 3. 25 patients with mild cognitive impairment (MCI) (MoCA = 22 ± 2 points); and 4. 21 patients with mild dementia due to Alzheimer’s disease (AD) (MoCA = 18 ± 4 points).

Results: All the cognitively healthy participants reached a maximum score of 10 points in CHT. Those feigning memory problems made 5 errors on average. Almost all of the patients with MCI reached 10 points (96%), and one had 9 points (4%). Most patients with mild dementia in AD scored 10 points (81%), 3 persons (14%) had 9 points and only 1 person (5%) had 8 points. No patient lost three points or more on the test. The test took 2 min on average.

Conclusion: CHT with a score of ≤ 8 points may point to memory deficit malingering in individuals without cognitive deficits or with mild cognitive deficits.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

手抛硬币试验用于检测假性记忆障碍与轻度认知障碍和轻度痴呆在阿尔茨海默病中的比较

目的:

手测硬币(CHT)可以用来测量记忆缺陷。这项研究的目的是找出哪些结果是由没有认知缺陷的个体或假装有认知障碍的人与真正的认知缺陷患者相比取得的。

患者和方法:

CHT是一种检测记忆缺陷的快速筛选工具。任务是记住考官在10次测试中用哪只手拿着一枚硬币。每对边的正确确定就给一分。总范围从0到10点。研究四组:1。112名蒙特利尔认知评估(MoCA)得分正常的老年人;28±1分)，动物语言流畅性测试(27±5分);2. 33例老年人在TMR中被问及故意记忆缺陷装病，得分正常(MoCA = 28±2分);3.轻度认知障碍(MCI) 25例(MoCA = 22±2分);和4。阿尔茨海默病(AD)所致轻度痴呆21例(MoCA = 18±4分)。

结果:

所有认知健康的参与者在CHT得分最高达到10分。那些假装记忆问题的人平均犯了5个错误。几乎所有MCI患者得分均为10分(96%)，1例为9分(4%)。AD中轻度痴呆患者得分10分(81%)最多，3人(14%)得分9分，仅有1人(5%)得分8分。没有病人在测试中失去3分或更多。测试平均耗时2分钟。

结论:

得分≤8分的CHT可能指没有认知缺陷或轻度认知缺陷的个体存在记忆缺陷。

关键字

硬币在手测试-装病-轻度认知障碍-阿尔茨海默氏症-痴呆症-记忆力

Keywords:

dementia – mild cognitive impairment – Coin in the Hand Test – Simulation – malingering – Alzheimer‘s disease – memory

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