Coin in the Hand Test for detection of malingering memory impairment in comparison with mild cognitive impairment and mild dementia in Alzheimer's disease
Abstract
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 LESS-THAN OR EQUAL TO 8 points may point to memory deficit malingering in individuals without cognitive deficits or with mild cognitive deficits.