Is the Clock Drawing Test a screening tool for the diagnosis of mild cognitive impairment? A systematic review

Ehreke, Lena; Luppa, Melanie; König, Hans‐Helmut; Riedel‐Heller, Steffi G.

doi:10.1017/s1041610209990676

Cited by 79 publications

(52 citation statements)

References 41 publications

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“…In more discrete conditions, however, the results are inconsistent. Our results suggest worse performance of MCI patients than NC, but a review of similar studies found negative results 30 . The second predic tor of CDT performance in our study may be related to the integration of different cognitive domains necessary for task performance.…”

Section: Discussioncontrasting

confidence: 55%

Mapping the clockworks: what does the Clock Drawing Test assess in normal and pathological aging?

Paula

Miranda

Moraes

et al. 2013

Arq. Neuro-Psiquiatr.

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Brief cognitive tests are widely used in neuropsychology and related areas, in order to assess and diagnose develop mental, neurological, and psychiatric conditions. The Clock Drawing Test (CDT) is also adopted as a screening tool for cognitive impairment in several conditions such as dementia, stroke, schizophrenia, mild cognitive impairment and mood disorders¹. The CDT basically consists of the drawing of dif ferent elements of a clock, including the clock face, numbers, and arrow-hands. The instructions and scoring methods vary according to each version. Influences of aging and education are also related to test performance, where children and the elderly perform worse than adults and lower education asso ciates with worse performance².Different versions of the CDT were developed. Although very similar and highly correlated³, they differ in diagnosis accuracy 4 and probably on the cognitive processes involved ABSTRACTThe Clock Drawing Test (CDT) is a cognitive screening tool used in clinical and research settings. Despite its role on the assessment of global cognitive functioning, the specific cognitive components required for test performance are still unclear. We aim to assess the role of executive functioning, global cognitive status, visuospatial abilities, and semantic knowledge on Shulman's CDT performance. Fifty-three mild cognitive impairment, 60 Alzheimer's dementia, and 57 normal elderly controls performed the CDT, the Frontal Assessment Battery, the Mini-Mental State Examination, the Stick Design Test, and a naming test (TN-LIN). An ordinal regression assessed specific neuropsychological in fluences on CDT performance. All the cognitive variables were related to the CDT, accounting for 53% of variance. The strongest association was between the CDT and executive functions, followed by global cognitive status, visuospatial processing, and semantic knowledge. Our result confirms the multidimensional nature of the test and the major role of executive functions on performance.Keywords: clock drawing test, executive functions, visuospatial abilities, semantic knowledge, dementia. Palavras-chave: teste do desenho do relógio, funções executivas, habilidades visioespaciais, conhecimento semântico, demência. RESUMO

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Section: Discussioncontrasting

confidence: 55%

Mapping the clockworks: what does the Clock Drawing Test assess in normal and pathological aging?

Paula

Miranda

Moraes

et al. 2013

Arq. Neuro-Psiquiatr.

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“…Moreover, the CDT requires different cognitive abilities including auditory and visual comprehension, concentration, visuospatial abilities, abstract conceptualization, and executive control (Shulman, 2000). However, the findings concerning the CDT's ability to differentiate between subjects with and without MCI are rather inconsistent (Lee et al, 2008;Pinto and Peters, 2009;Ehreke et al, 2010). For example, Yamamoto et al (2004) found that the CDT has utility to screen for MCI, whereas Lee et al (2008) did not recommend the use of the CDT as a screening instrument for MCI.…”

Section: Introductionmentioning

confidence: 99%

Clock Drawing Test – screening utility for mild cognitive impairment according to different scoring systems: results of the Leipzig Longitudinal Study of the Aged (LEILA 75+)

Ehreke

Luck

Luppa

et al. 2011

Int. Psychogeriatr.

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“…la prueba del dibujo del reloj (PDR), ha sido empleada para la detección de demencia, siendo de fácil y rápida administración, permite evaluar las siguientes habilidades cognitivas: comprensión auditiva, planeamiento, memoria visual, reconstrucción de una imagen gráfica, habilidades viso-espaciales, programación motora y ejecución, conocimiento numérico y concentración (15,18) ; pero no permite detectar deterioro cognitivo mínimo (DCM) (19) . Una revisión de Pinto et al, muestra diferentes formas de administrar la PDR, así como diferentes maneras de calificar la prueba (20) , cualitativa y cuantitativamente, siendo estas últimas mejor verificables y reproducibles.…”

Section: Introductionunclassified

Validación de la prueba de dibujo del reloj - versión de Manos - como prueba de cribado para detectar demencia en una población adulta mayor de Lima, Perú

Custodio¹,

García²,

Montesinos³

et al. 2011

Rev Peru Med Exp Salud Publica

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Introducción. La prueba de dibujo del reloj versión de Manos (PDR-M) es un instrumento de evaluación cognitiva breve para la detección de demencia. Objetivos. Evaluar la validez y confiabilidad de la PDR-M para discriminar entre pacientes con demencia y sujetos controles sanos. Materiales y métodos. Se evaluaron sujetos mayores de 65 años de edad, excluyendo los que presentaban enfermedades concomitantes graves y con dificultades auditivas o visuales. Se recogieron datos demográficos y se les realizó PDR-M y Mini Mental State Examination (MMSE). A los individuos del grupo de demencia se les realizó además evaluaciones clínicas, de laboratorio, neuropsicológicas y tomografía cerebral. Se calculó la sensibilidad y especificidad de la PDR-M así como el área bajo la curva ROC. Resultados. Se evaluó 210 individuos, 103 con diagnóstico confirmado de demencia y 107 controles sanos, con edad y sexo similares en ambos grupos; y mayor nivel educativo en el grupo control. Estableciendo un punto de corte de 7 se obtuvo una sensibilidad de 99,0% y una especificidad de 83,5%. Cuando se compararon las áreas bajo la curva ROC de la PDR-M y del MMSE no se encontraron diferencias significativas. Conclusiones. La PDR-M es un instrumento breve y confiable para la detección de demencia en la población urbana de Lima en el Perú. VALIDATION OF THE CLOCK DRAWING TEST -MANOS´ VERSION -AS A SCREENING TEST FOR DETECTION OF DEMENTIA IN OLDER PERSONS OF LIMA; PERU ABSTRACT Introduction. The clock drawing test (PDR-M) -Manos´ version -is a brief cognitive assessment tool for dementia detection.Objectives. To assess the validity and reliability of the PDR-M to discriminate between patients with dementia and healthy control subjects. Materials and methods. We evaluated subjects over 65 years of age, excluding those with severe concomitant diseases and those with hearing or visual impairment. We obtained demographic data and performed the PDR-M and Mini Mental State Examination (MMSE). Subjects of the dementia group were also submitted to clinical, laboratory and neuropsychological evaluations as well as computed tomography scanning. Sensitivity and specificity of the PDR-M were calculated as well as the area under the ROC curve. Results. We evaluated 210 individuals, 103 with confirmed diagnosis of dementia and 107 healthy controls with similar age and sex in both groups, but a higher educational level in the control group. Setting a cutoff point of 7, a sensitivity of 99.0% and a specificity of 83.5% were found. When comparing the areas under the ROC curves of the PDR-M and MMSE we found no statistically significant difference. Conclusions. The PDR-M is a brief and reliable instrument for the detection of dementia in the urban population of Lima, Peru.

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Is the Clock Drawing Test a screening tool for the diagnosis of mild cognitive impairment? A systematic review

Abstract: CDT should not be used for MCI-screening.

Cited by 79 publications

References 41 publications

Mapping the clockworks: what does the Clock Drawing Test assess in normal and pathological aging?

Mapping the clockworks: what does the Clock Drawing Test assess in normal and pathological aging?

Clock Drawing Test – screening utility for mild cognitive impairment according to different scoring systems: results of the Leipzig Longitudinal Study of the Aged (LEILA 75+)

Validación de la prueba de dibujo del reloj - versión de Manos - como prueba de cribado para detectar demencia en una población adulta mayor de Lima, Perú

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