Handwriting is a complex cognitive and motor skill that requires the activation of a broad brain network. Previous studies have shown that handwriting ability gradually declines with aging, especially during the course of neurodegenerative disorders, including Alzheimer’s disease (AD) and Parkinson’s disease (PD). Additionally, a correlation has been found between the severity of handwriting disruption and the severity of cognitive impairment. The graphic process is affected by cognitive decline and deterioration can be detected. Hence, handwriting may provide relevant information on general cognitive status. For this reason, researchers have also investigated the possibility of using handwriting alterations caused by neurodegenerative disorders as diagnostic signs, in order to support the diagnosis process itself (De Stefano et al., 2019). To achieve this goal, writing tasks and handwriting analysis have been used. In forensic contexts, handwriting analysis plays an important role during the assessment of testamentary capacity, providing valuable evidence of the cognitive state of the testator during the writing of his or her last will. Neuropsychological autopsy is the posthumous evaluation process of the deceased in order to determine his or her mental state and, consequently, his or her testamentary capacity. Neuropsychological autopsy is particularly critical in cases where prior cognitive assessment is not available. “Neuropsychologists, independently or as part of a board of consultants, are, therefore, frequently requested to give an expert opinion on the competence of cognitively impaired elderly testators” (Zago & Bolognini, 2022). The present work aims at identifying a semiquantitative scoring system, based on a prespecified taxonomy of writing errors, in order to implement inter-rater reliability and its correlation with standard tests measuring neuropsychological status. Analysis of writing errors could be capable of predicting the general mental status of individuals. Data was collected from available medical records at the forensic neuropsychology service of an academic clinical center. Patients were referred to the service for cognitive functioning evaluation aimed at renewal or revision of their driving license. The phrases written by the subjects were collected from the Mini-Mental State Examination (MMSE) administered during the assessment (Folstein et al., 1975). Even though several publications have shown that writing is impaired in demented patients, it is challenging to apply these data to evaluate a single case—although it is what experts are required for judicial purposes. On the contrary, a quantitative score that accurately predicts significant mental decline would be a crucial tool in the forensic analysis of handwriting. Therefore, quantitative handwriting analysis may be a useful addition to the actual procedure in forensic assessment of testamentary capacity. Furthermore, novel interesting perspectives involving the application of Artificial Intelligence (AI) will be presented.

It's written between the lines: Writing errors as predictors of General Mental Status

BANDIERA, STEFANIA
2021/2022

Abstract

Handwriting is a complex cognitive and motor skill that requires the activation of a broad brain network. Previous studies have shown that handwriting ability gradually declines with aging, especially during the course of neurodegenerative disorders, including Alzheimer’s disease (AD) and Parkinson’s disease (PD). Additionally, a correlation has been found between the severity of handwriting disruption and the severity of cognitive impairment. The graphic process is affected by cognitive decline and deterioration can be detected. Hence, handwriting may provide relevant information on general cognitive status. For this reason, researchers have also investigated the possibility of using handwriting alterations caused by neurodegenerative disorders as diagnostic signs, in order to support the diagnosis process itself (De Stefano et al., 2019). To achieve this goal, writing tasks and handwriting analysis have been used. In forensic contexts, handwriting analysis plays an important role during the assessment of testamentary capacity, providing valuable evidence of the cognitive state of the testator during the writing of his or her last will. Neuropsychological autopsy is the posthumous evaluation process of the deceased in order to determine his or her mental state and, consequently, his or her testamentary capacity. Neuropsychological autopsy is particularly critical in cases where prior cognitive assessment is not available. “Neuropsychologists, independently or as part of a board of consultants, are, therefore, frequently requested to give an expert opinion on the competence of cognitively impaired elderly testators” (Zago & Bolognini, 2022). The present work aims at identifying a semiquantitative scoring system, based on a prespecified taxonomy of writing errors, in order to implement inter-rater reliability and its correlation with standard tests measuring neuropsychological status. Analysis of writing errors could be capable of predicting the general mental status of individuals. Data was collected from available medical records at the forensic neuropsychology service of an academic clinical center. Patients were referred to the service for cognitive functioning evaluation aimed at renewal or revision of their driving license. The phrases written by the subjects were collected from the Mini-Mental State Examination (MMSE) administered during the assessment (Folstein et al., 1975). Even though several publications have shown that writing is impaired in demented patients, it is challenging to apply these data to evaluate a single case—although it is what experts are required for judicial purposes. On the contrary, a quantitative score that accurately predicts significant mental decline would be a crucial tool in the forensic analysis of handwriting. Therefore, quantitative handwriting analysis may be a useful addition to the actual procedure in forensic assessment of testamentary capacity. Furthermore, novel interesting perspectives involving the application of Artificial Intelligence (AI) will be presented.
2021
It's written between the lines: Writing errors as predictors of General Mental Status
Forensic psychology
Handwriting analysis
Writing errors
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12608/40016