Early Detection of Alzheimer’s Disease Based on the Patient’s Creative Drawing Process: First Results with a Novel Neuropsychological Testing Method

Abstract

Based on the knowledge of art therapy, we developed a new neuropsychological drawing test in order to identify individuals with mild cognitive impairment (MCI) as well as dementia patients and healthy controls (HC). By observing a variety of drawing characteristics of 92 participants with a mean age of 67.7, art therapy and dementia experts discriminate HC from MCI, early dementia of the Alzheimer-type (eDAT), and moderate dementia of the Alzheimer-type (mDAT) by the process analysis of tree drawings on a digitizing tablet. The art therapist's average categorical rating of healthy and MCI or demented individuals matched the clinical diagnosis by 88%. In a first small study, we analyzed interrater reliability, sensitivity, specificity, negative and positive predicted values of our tree drawing test (TDT) in comparison with the clock drawing test (CDT). Similar values of moderate interrater reliability were found for the TDT (0.56) as well as for the CDT (0.54). A significant high sensitivity of 0.9 within this binary impairment scale (HC versus impaired or demented) can be demonstrated. Substantial values for the specificity (0.67) could be obtained that however remain under a perfect value of the CDT (1.0). Considering 31 individuals that received the clinical diagnosis "impaired or demented" the TDT shows a higher recognition rate for the MCI group than the CDT. Furthermore in 8 of 12 borderline cases of clinical diagnosis, the outcome of the TDT diagnosis was consistent with the final clinical result.

Traces of health—A landscape design task as a diagnostic aid for detecting mental burden? A qualitative focus group study

“…Comparable to the study design of Heymann et al (2018), a blinded-randomized analysis of the video material by a total of 56 experts from the fields "Gardening and landscape design" (GL) (n = 17, 3 female Mean age: 26.53 years); "Psychology and psychotherapy" (PP) (n = 15; 9 female; mean age: 23.07) and "Art therapy and Theater Pedagogy" (AT) (n = 24; 18 female; mean age 24.67 years) was conducted. In a first step, the topic of the discussion was introduced to the experts by means of viewing a video of landscape design as a basis for discussion.…”

Evaluation of Digital Drawing Tests and Paper-and-Pencil Drawing Tests for the Screening of Mild Cognitive Impairment and Dementia: A Systematic Review and Meta-analysis of Diagnostic Studies

“…Due to the weakness of paper-and-pencil drawing tests and the advancement of technology, digital drawing tests have evolved over the past decade. Digital drawing tests can record and assess drawing characteristics such as total time spent, contour, and drawing methods, which can be considered when discriminating between MCI and dementia (Heymann et al, 2018). Studies showed that on-air movements can enhance the sensitivity of identifying patients with MCI (Garre-Olmo et al, 2017;Müller et al, 2017).…”