The concept of ‘testament’: Item-level analysis and relationship with demographic, clinical, and testamentary capacity-related variables in healthy adults

Expressed knowledge of the concept of 'testament' (will) by the testator represents a basic level of understanding of the nature of a will, yet the specific wordings used by healthy adults to define this concept remains to be determined. This study aimed to examine how the concept of a will is defined by healthy adults through an item-level analysis of the Testament Definition Scale (TDS), a brief standardized measure for the assessment of testamentary capacity. The TDS was administered to 82 healthy adults (mean age = 65.60 ± 11.65 years), together with measures of global cognition (Montreal Cognitive Assessment, Mini-Mental State Examination), executive functioning (Frontal Assessment Battery), depression (Beck Depression Inventory-II), and testamentary capacity (Testamentary Capacity Assessment Tool). Item-level analysis showed that TDS items differ in difficulty, discriminability, and cotribution to the total score. Significant relationships were also found between age, education, global cognition, and each TDS item. Conversely, no associations emerged with sex, executive functioning, and depression. These findings contribute to a refined interpretation of TDS scores and support the value of item-level analysis for understanding the ability to conceptualize a will in relation to age, education, and cognitive efficiency.