Although applicable to people who suffer from mild cognitive decline, the instrument cannot provide relevant information in people with more severe cognitive incapacities.
Exclusion criteria for patients: Under 18; likely to die within 1 week (as assessed by treating physician or senior nurse); unable to identify a primary family carer, unable to provide informed consent due to cognitive impairment or incapacity to comprehend and speak English (as assessed by treating physician, senior nurse or research assistant).
Of the remaining 278 women, 198 fulfilled the inclusion criteria, while 80 women did not: 69 were not able to speak sufficient German, and 11 had severe cognitive or psychological incapacities and were not able to give informed consent to participate in the study.
Participants provided written informed consent: witnessed oral consent in the case of illiteracy or next-of-kin agreement in the case of incapacity or cognitive impairment.
Several studies have pointed out the association between cognitive deficits and functional incapacity among community-residing elderly populations [ 23, 39, 40].
Studies with community-dwelling elderly individuals also showed an association between IADL and/or ADL functional incapacity and cognitive deficit, as well as with an individual's level of education [ 2, 6, 40].
Moreover, reported weight loss was confirmed by a second source in the case of incapacity or cognitive impairment (this was the case for 2562 participants), and in the case of discrepancy, caregiver report was given salience.
In another study with Brazilian institutionalized elderly individuals, those who had cognitive impairment presented more functional incapacity than those who had not [ 18].
Roughly, on the cognitive prong of a mental incapacity test, an agent is found not guilty if (a) he or she did not understand the nature of the action they performed, or, if they did understand its nature, did not understand that it was wrong, and (b) these failures of understanding were due to a mental illness.
The participants considered cognitive difficulties more debilitating than physical incapacities; likewise, physical symptoms were perceived easier to tolerate than cognitive ones.
