Relationship between clock drawing test performance and regional cerebral blood flow in Alzheimer's disease: A single photon emission computed tomography study

Ueda, Hiroyuki; Kitabayashi, Yurinosuke; Narumoto, Jin; Nakamura, Kaeko; Kita, Hitoshi; Kishikawa, Yusuke; Fukui, Kenji

doi:10.1046/j.1440-1819.2002.00940.x

Cited by 55 publications

(46 citation statements)

References 31 publications

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“…Especially for screening in situations with only slightly affected individuals, the CDT is not suffi cient [57] . This is in accordance with the correlation of CDT results with left posterior temporal function being one of the regions AD spreads out to but does not begin in [58] .…”

Section: Evaluation Of Single-item Screening Measuressupporting

confidence: 90%

Screening for Cognitive Impairment: A Triage for Outpatient Care

Beinhoff

Hilbert

Bittner

et al. 2005

Dement Geriatr Cogn Disord

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The current increase in aged individuals in number and proportionof the general population warrants dependable strategies to improve early detection of cognitive impairment. It was the goal of the present study to develop a triage for bedside testing and outpatient ser vices. In a prospective clinical cohort study at the outpatient Memory Clinic, University of Ulm, Germany, 232 subjects were diagnosed with Alzheimer’s disease [AD; NINCDS-ADRDA criteria; n = 66; age 65.9 ± 7.3 years (mean ± SD); Mini Mental State Examination (MMSE) score 23.4 ± 4.1], mild cognitive impairment (MCI; criteria of Petersen et al.; n = 48; age 66.4 ± 7.1 years; MMSE score 28.3 ± 1.5), and major depressive disorder (DSM-IV criteria; n = 61; age 63.4 ± 8.0 years; MMSE score 28.6 ± 1.6). Diagnosis was secured with extensive neuropsychological, clinical, radiological, and laboratory investigations. Six brief screening tests including the Memory Impairment Screen (MIS), Letter Sorting Test (LST), Verbal Fluency (VF), and Clock Drawing Test (CDT) were assessed independently from the diagnostic procedure. We compared single items and composite scores. LST yielded a diagnostic accuracy of 0.81 and 0.62 for AD and MCI patients versus controls, respectively. With the MIS, diagnostic accuracy was 0.89 and 0.71, respectively. With a combination of LST, MIS, VF, and CDT, a sensitivity for AD and MCI patients of 1.00 and 0.83 was achieved. Thus, single-item screening (e.g. LST, VF) taking little more than 1 min and suitable for bedside testing or brief screening in the general practitioner’s office yields diagnostic accuracy comparable to standard laboratory tests for other diseases. A composite of screening tests suitable for application in general outpatient care in neurological and psychiatric services reliably detects patients with AD and MCI.

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Section: Evaluation Of Single-item Screening Measuressupporting

confidence: 90%

Screening for Cognitive Impairment: A Triage for Outpatient Care

Beinhoff

Hilbert

Bittner

et al. 2005

Dement Geriatr Cogn Disord

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“…Other authors 31 , wor king with AD and frontotemporal dementia patients (including semantic dementia), found quantitative and qualitative impairments in CDT performance that may, at least partial ly, be related to semantic deficits. Functional neuroimaging studies with AD patients identified posterior left temporal lobe (areas related to language and semantic processing) blood flow to be a predictor of CDT performance 32,33 . Finally, visuospatial abilities were related to CDT perfor mance in our sample.…”

Section: Discussionmentioning

confidence: 99%

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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“…Besides, most previous studies emphasized the use of quantitative analyses of the CDT results, leaving detailed qualitative analyses of the results somewhat neglected. Despite the existence of reports regarding qualitative analyses of the CDT results in AD and vascular dementia (VD) patients, those focusing on MCI subjects are still lacking [17,18]. The purpose of this study was to warrant the validity of the CDT as a screening method for detecting MCI by determining an appropriate scoring protocol with an optimal cutoff point and qualitative features.…”

Section: Introductionmentioning

confidence: 99%

The Clock Drawing Test as a Valid Screening Method for Mild Cognitive Impairment

Yamamoto

Mogi

Umegaki

et al. 2004

Dement Geriatr Cogn Disord

103

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To validate the Clock Drawing Test (CDT) as a screening method for detecting mild cognitive impairment (MCI) and to find the appropriate scoring protocol and its cutoff point, we compared the sensitivity and specificity of three CDT protocols. Subjects included 219 outpatients with memory complaints, who were attending the geriatric memory clinic. Cahn’s protocol, with a cutoff point of 7, was more successful at differentiating clinically diagnosed MCI subjects from normal elderly individuals, with higher sensitivity (74.7%) and specificity (75.6%), than were the other protocols. The CDT, as a handy screening method, may be useful for clinicians to reliably identify subjects with MCI, and it may contribute to early detection of dementia.

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Relationship between clock drawing test performance and regional cerebral blood flow in Alzheimer's disease: A single photon emission computed tomography study

Cited by 55 publications

References 31 publications

Screening for Cognitive Impairment: A Triage for Outpatient Care

Screening for Cognitive Impairment: A Triage for Outpatient Care

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

The Clock Drawing Test as a Valid Screening Method for Mild Cognitive Impairment

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