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Research ArticleRegular Articles

Cognitive Fluctuations and the Lucid Interval in Dementia: Implications for Testamentary Capacity

Kenneth I. Shulman, Ian M. Hull, Sam DeKoven, Sean Amodeo, Brian J. Mainland and Nathan Herrmann
Journal of the American Academy of Psychiatry and the Law Online September 2015, 43 (3) 287-292;
Kenneth I. Shulman
Drs. Shulman and Herrmann are Professors and Mr. DeKoven is a summer student, Department of Psychiatry, Sunnybrook Health Sciences Centre, and Mr. Amodeo is a medical student, Faculty of Medicine, University of Toronto, Ontario Canada. Mr. Hull is a Partner, Hull & Hull LLP, Toronto, Ontario, Canada. Mr. Mainland is a doctoral candidate, Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
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Ian M. Hull
Drs. Shulman and Herrmann are Professors and Mr. DeKoven is a summer student, Department of Psychiatry, Sunnybrook Health Sciences Centre, and Mr. Amodeo is a medical student, Faculty of Medicine, University of Toronto, Ontario Canada. Mr. Hull is a Partner, Hull & Hull LLP, Toronto, Ontario, Canada. Mr. Mainland is a doctoral candidate, Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
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Sam DeKoven
Drs. Shulman and Herrmann are Professors and Mr. DeKoven is a summer student, Department of Psychiatry, Sunnybrook Health Sciences Centre, and Mr. Amodeo is a medical student, Faculty of Medicine, University of Toronto, Ontario Canada. Mr. Hull is a Partner, Hull & Hull LLP, Toronto, Ontario, Canada. Mr. Mainland is a doctoral candidate, Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
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Sean Amodeo
Drs. Shulman and Herrmann are Professors and Mr. DeKoven is a summer student, Department of Psychiatry, Sunnybrook Health Sciences Centre, and Mr. Amodeo is a medical student, Faculty of Medicine, University of Toronto, Ontario Canada. Mr. Hull is a Partner, Hull & Hull LLP, Toronto, Ontario, Canada. Mr. Mainland is a doctoral candidate, Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
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Brian J. Mainland
Drs. Shulman and Herrmann are Professors and Mr. DeKoven is a summer student, Department of Psychiatry, Sunnybrook Health Sciences Centre, and Mr. Amodeo is a medical student, Faculty of Medicine, University of Toronto, Ontario Canada. Mr. Hull is a Partner, Hull & Hull LLP, Toronto, Ontario, Canada. Mr. Mainland is a doctoral candidate, Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
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Nathan Herrmann
Drs. Shulman and Herrmann are Professors and Mr. DeKoven is a summer student, Department of Psychiatry, Sunnybrook Health Sciences Centre, and Mr. Amodeo is a medical student, Faculty of Medicine, University of Toronto, Ontario Canada. Mr. Hull is a Partner, Hull & Hull LLP, Toronto, Ontario, Canada. Mr. Mainland is a doctoral candidate, Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
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Abstract

The lucid interval is a long-held legal concept widely accepted in case law as a possible means of countering a challenge to testamentary and related capacities. In parallel, the clinical phenomenon of cognitive fluctuations has been considered a common element of several neurodegenerative disorders (dementias), including Alzheimer Disease, but is especially prevalent in vascular dementia and dementia with Lewy bodies. In this article, we review the objective evidence for cognitive fluctuations in dementia and the implications for the validity of the legal notion of the lucid interval cited in recent case law. The literature on cognitive fluctuations in dementia shows that such fluctuations largely affect attention and alertness, rather than memory or the higher level executive functions that are essential components of testamentary capacity. Moreover, these fluctuations are small in magnitude and very short in duration. These findings cast doubt on the validity of the lucid interval and invite a critical rethinking of this legal concept as applied to will challenges involving testators with dementia.

Footnotes

  • Disclosures of financial or other potential conflicts of interest: None.

  • © 2015 American Academy of Psychiatry and the Law
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Journal of the American Academy of Psychiatry and the Law Online: 43 (3)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 43, Issue 3
1 Sep 2015
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Cognitive Fluctuations and the Lucid Interval in Dementia: Implications for Testamentary Capacity
Kenneth I. Shulman, Ian M. Hull, Sam DeKoven, Sean Amodeo, Brian J. Mainland, Nathan Herrmann
Journal of the American Academy of Psychiatry and the Law Online Sep 2015, 43 (3) 287-292;

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Cognitive Fluctuations and the Lucid Interval in Dementia: Implications for Testamentary Capacity
Kenneth I. Shulman, Ian M. Hull, Sam DeKoven, Sean Amodeo, Brian J. Mainland, Nathan Herrmann
Journal of the American Academy of Psychiatry and the Law Online Sep 2015, 43 (3) 287-292;
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  • Article
    • Abstract
    • Testamentary Capacity
    • The Lucid Interval: A Legal Perspective
    • Cognitive Fluctuations: A Medical Perspective
    • Length and Frequency of a Lucid Interval: A Legal Perspective
    • Length and Frequency of Cognitive Fluctuations: A Medical Perspective
    • The Lucid Interval: A Case Study
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