The clock drawing test in primary care: sensitivity in dementia detection and specificity against normal and depressed elderly

Abstract

The use of the CDT in the detection of dementia syndromes is likely to be more relevant in the primary care context than in specialist settings. The CDT provides good sensitivity and specificity but may not be as sensitive or specific in the general community as previous studies have suggested, particularly in mild dementia. Community-based late life depression does not appear to alter the specificity of the CDT.

The Clock-Drawing Test in Elderly Italian Community Dwellers: Associations with Sociodemographic Status and Risk Factors for Vascular Cognitive Impairment

“…No association between CDT performance and other factors known to affect cognitive status, such as decreased serum folate and vitamin B 12 levels [35], were found, whereas the lack of relationship between CDT and the presence of depressive symptoms confirms previous reports about the good specificity of CDT against depression in the elderly [36]. As far as the use of vitamin supplements and estrogen replacement therapy is concerned, in the present study the number of subjects reporting use of these agents was too little (less than 2%) for a meaningful statistical analysis.…”

Literature Review of the Clock Drawing Test as a Tool for Cognitive Screening

“…Other studies use selective control groups, excluding patients with memory problems or a family history of dementia [25] , or a history of psychological or neurological illness [27] . The use of general community controls leads to a lower specificity, but it reflects the heterogeneous population a clinician encounters in practice [41] .…”

“…The CDT was significantly correlated to other measures of dementia severity, such as the Dementia Rating Scale, but not to age or duration of symptoms in either AD patients or controls [26] . Kirby et al [41] used the same scoring system, but in a more heterogeneous control group of community-dwelling participants without depression or dementia, and obtained reasonable percentages of sensitivity (76%) and specificity (81%) [41] .…”

Cognitive Estimation in Non-demented Parkinson's Disease

“…The background neuropsychological tests were administered to the PD patients as part of their inpatient stay but were also administered to the healthy control group who took part in the study. Clock Drawing was administered (Agrell & Dehlin, 1998;Esteban-Santillan, Praditsuwan, Veda, & Geldmacher, 1998;Storey, Rowland, Basic, & Conforti, 2001), as it is considered predictive of dementia in primary care (Kirby, Denihan, Bruce, Coakley, & Lawlor, 2001). Abstract reasoning was assessed using Raven's Coloured Progressive Matrices (Raven, Raven, & Court, 1998), verbal intelligence through the Brief Intelligence Test , and general knowledge through the WAIS information subtest (Wechsler, 1997).…”