The Three-Item Clock-Drawing Test: A Simplified Screening Test for Alzheimer’s Disease

Lin, Ker Neng; Wang, Pei Ning; Chen, Chien; Chiu, Yu Hong; Kuo, Chi Chung; Chuang, Ya Yun; Liu, Hsiu Chih

doi:10.1159/000067026

Cited by 58 publications

(45 citation statements)

References 19 publications

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“…In general practice, the CDT is in wide use and has been shown to have a sensitivity of about 70-75% and a specifi city of about 65-79% [56] , which is comparable to the present study. However, its practicality is limited especially in subjects with physical handicaps and the results of the present study show that other single-item screening tests give better results.…”

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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“…Lin et al [38] derived a simplified system to differentiate early to mild AD in a population in Taiwan. Age and education were significantly related to the CDT, although the correlation was low.…”

Section: Cdt Scoring Systemsmentioning

confidence: 99%

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

Pinto¹,

Peters²

2009

Dement Geriatr Cogn Disord

196

151

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Background/Aims: The Clock Drawing Test (CDT) is used in clinical practice for the screening of cognitive disorders. This systematic review aims to present and discuss the CDT scoring methods available in the literature, in order to find differences in administration and utility of the CDT. Methods: A literature search was carried out in Medline (1966 to June 2008), Psychinfo (1967 to June 2008) and EMBASE (1980 to June 2008). Results: All studies showed good interrater and test-retest reliabilities. The correlation with other standard screening tests was statistically significant in most studies, but the results were influenced by age, education and language. In studies that included patients with mild or questionable dementia, the CDT had a low sensitivity and variable specificity. Conclusion: The CDT has the characteristics of a good screening method for moderate and severe dementia. However, the scoring method used and potential confounders need to be taken into consideration.

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“…The results described above show that both scoring systems had good inter-system and inter-rater reliability and both correlated equally well with the true diagnosis of dementia. Earlier studies by Scanlan et al (2002) and Lin et al (2003) where simple scoring systems were compared to more complex systems, also concluded that the simple systems had a rather good accuracy when compared to the more complex systems.…”

Section: Discussionmentioning

confidence: 97%