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

Download PDF Czech version

Authors: A. Bartoš ^1–3; M. Raisová ^1–3
Authors‘ workplace: 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: Cesk Slov Neurol N 2019; 82(3): 316-321
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2019316

Overview

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

Sources

1. Raboch J, Hrdlička M, Mohr P et al. DSM-5®: diagnostický a statistický manuál duševních poruch. 1. vyd. Praha: Hogrefe – Testcentrum 2015.

2. Preiss M, Preiss J, Krámská L et al. Nedostatečná snaha podat dobrý výkon. Psychiatrie 2012; 16(4): 202–209.

3. Kapur N. The Coin in the Hand Test: a new bedside test for the detection of malingering in patients with suspected memory disorder. J Neurol Neurosurg Psychiatry 1994; 57(3): 385–386.

4. Schroeder RW, Peck CP, Buddin WH Jr et al. The Coin in the Hand Test and dementia: more evidence for a screening test for neurocognitive symptom exaggeration. Cogn Behav Neurol 2012; 25(3): 139–143. doi: 10.1097/ WNN.0b013e31826b71c1.

5. Bartoš A, Raisová M. Testy a dotazníky pro vyšetřování kognitivních funkcí, nálady a soběstačnosti: Praha: Mladá Fronta 2015.

6. Folstein MF, Folstein SE, McHugh PR. „Mini-Mental State“. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12(3): 189–198.

7. Nasreddine ZS, Phillips NA, Bedirian V et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53(4): 695–699. doi: 10.1111/ j.1532-5415.2005.53221.x.

8. Bartoš A, Raisová M. The Mini-Mental State Examination: Czech norms and cutoffs for mild dementia and mild cognitive impairment due to Alzheimer‘s disease. Dement Geriatr Cogn Disord 2016; 42(1–2): 50–57. doi: 10.1159/ 000446426.

9. Bartoš A, Orlíková H, Raisová M et al. Česká tréninková verze Montrealského kognitivního testu (MoCA-CZ1) k časné detekci Alzheimerovy nemoci. Cesk Slov Neurol N 2014; 77/ 110(5): 587–594.

10. Kelly PJ, Baker GA, van den Broek MD et al. The detection of malingering in memory performance: the sensitivity and specificity of four measures in a UK population. Br J Clin Psychol 2005; 44(Pt 3): 333–341.

11. Hanley JR, Baker GA, Ledson S. Detecting the faking of amnesia: a comparison of the effectiveness of three different techniques for distinguishing simulators from patients with amnesia. J Clin Exp Neuropsychol 1999; 21(1): 59–69. doi: 10.1076/ jcen.21.1.59.936.

12. Baker GA, Hanley JR, Jackson HF et al. Detecting the faking of amnesia: performance differences between simulators and patients with memory impairment. J Clin Exp Neuropsychol 1993; 15(5): 668–684. doi: 10.1080/ 01688639308402588.

13. Cochrane HJ, Baker GA, Meudell PR. Simulating a memory impairment: can amnesics implicitly outperform simulators? Br J Clin Psychol 1998; 37(Pt 1): 31–48.

14. Rudman N, Oyebode JR, Jones CA et al. An investigation into the validity of effort tests in a working age dementia population. Aging Ment Health 2011; 15(1): 47–57. doi: 10.1080/ 13607863.2010.508770.

15. Preiss M, Příhodová T, Raisová M et al. Měření simulace – Test mince v ruce. Cesk Slov Neurol N 2017; 80/ 113(3): 307–315. doi: 10.14735/ amcsnn2017307.

16. Bartoš A. Netestuj, ale POBAV – písemné zá-
měrné Pojmenování OBrázku A jejich Vybavení jako
krátká kognitivní zkouška. Cesk Slov Neurol N 2016;
79/ 112(6): 671–679.

17. Bartoš A. Krátký test slovní paměti pomocí věty u Alzheimerovy nemoci. Cesk Slov Neurol N 2017; 80/ 113(6): 679–684. doi: 10.14735/ amcsnn2017679.

18. Bartoš A. Test gest (TEGEST) k rychlému vyšetření epizo-dické paměti u mírné kognitivní poruchy. Cesk Slov Neurol N 2018; 81/ 114(1): 37–44. doi: 10.14735/ amcsnn201837.

19. Bartoš A, Fayette D. Validation of the Czech Montreal Cognitive Assessment for Mild Cognitive Impairment due to Alzheimer Disease and Czech norms in 1,552 elderly persons. Dement Geriatr Cogn Disord 2018; 46(5–6): 335–345. doi: 10.1159/ 000494489.

20. Almeida OP, Almeida SA. Short versions of the geriatric depression scale: a study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV. Int J Geriatr Psychiatry 1999; 14(10): 858–865.

21. Bartoš A, Martínek P, Bezdíček O. Dotazník funkčního stavu FAQ-CZ – Česká verze pro zhodnocení každodenních aktivit pacientů s Alzheimerovou nemocí. Psychiatr Praxi 2008; 9(1): 31–34.

22. Bartoš A, Zach P, Diblíková F et al. Vizuální kategorizace mediotemporální atrofie na MR mozku u Alzheimerovy nemoci. Psychiatrie 2007; 11 (Suppl 3): 49–52.

23. Bartoš A, Čechová L, Švarcová J et al. Likvorový triplet (tau proteiny a beta-amyloid) v diagnostice Alzheimerovy-Fisherovy nemoci. Cesk Slov Neurol N 2012; 75/ 108(5): 587–594.

24. Winblad B, Palmer K, Kivipelto M et al. Mild cognitive impairment – beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med 2004; 256(3): 240–246. doi: 10.1111/ j.1365-2796.2004.01380.x.

25. McKhann GM, Knopman DS, Chertkow H et al. 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. Alzheimers Dement 2011; 7(3): 263–2269. doi: 10.1016/ j.jalz.2011.03.005.

26. Dušek L, Pavlík T, Jarkovský J et al. Hodnocení diagnostických testů – křivky ROC. Cesk Slov Neurol N 2011; 74/ 107(4): 493–499.

27. Griffin GA, Glassmire DM, Henderson EA et al. Rey II: Redesigning the Rey screening test of malingering. J Clin Psychol 1997; 53(7): 757–768.

28. Green P, Rohling ML, Lees-Haley PR et al. Effort has a greater effect on test scores than severe brain injury in compensation claimants. Brain Inj 2001; 15(12): 1045–1060. doi: 10.1080/ 02699050110088254.

29. Larrabee GJ. Introduction: Malingering, research designs, and base rates. In: Larrabee GJ (ed.). Assessment of malingered neuropsychological deficits. New York: Oxford University Press 2007: 3–13.

30. Hegedish O, Kivilis N, Hoofien D. Preliminary validation of a new measure of negative response bias: The Temporal Memory Sequence Test. Appl Neuropsychol Adult 2015; 22(5): 348–354. doi: 10.1080/ 23279095.2014.940420.

31. Silverberg ND, Hanks RA, Buchanan L et al. Detecting response bias with performance patterns on an expanded version of the Controlled Oral Word Association Test. Clin Neuropsychol 2008; 22(1): 140–157.

32. Johnson DK, Storandt M, Morris JC et al. Longitudinal study of the transition from healthy aging to Alzheimer disease. Arch Neurol 2009; 66(10): 1254–1259. doi: 10.1001/ archneurol.2009.158.