Necker cube copying may not be appropriate as an examination of dementia: reanalysis from the <scp>T</scp>ajiri Project

Oonuma, Jiro; Kasai, Mari; Meguro, Mitsue; Akanuma, Kyoko; Yamaguchi, Satoshi; Meguro, Kenichi

doi:10.1111/psyg.12161

Cited by 2 publications

(3 citation statements)

References 30 publications

(46 reference statements)

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“…Therefore, further analysis would be necessary to confirm that the 3 mm vertex criterion is appropriate, as their score using this criterion was six out of eight, to distinguish community-dwelling elderly from patients with cognitive impairments of dementia by comparing the characteristics assessed by the 3-vertex criterion with the results of other evaluation methods and a greater variety of participants. 22,23 All of the participants in our study demonstrated either one parallel line error or none, regardless of their age, years of education, and MoCA-J scores. Therefore, it can be said that the parallel line error is small in the elderly.…”

Section: Discussionmentioning

confidence: 67%

“…If neuropsychological symptoms, such as visuo‐perceptual disability, occur as part of the dementia seen with Alzheimer's disease, 15 the number of correct vertices would be expected to be less than six using the 3 mm vertex criterion. Therefore, further analysis would be necessary to confirm that the 3 mm vertex criterion is appropriate, as their score using this criterion was six out of eight, to distinguish community‐dwelling elderly from patients with cognitive impairments of dementia by comparing the characteristics assessed by the 3‐vertex criterion with the results of other evaluation methods and a greater variety of participants 22,23 …”

Section: Discussionmentioning

confidence: 99%

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Assessment of cube‐copying among community‐dwelling elderly living in Japan using the vertex criterion and parallelism

2021

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Background: The cube-copying test is used to assess cognitive function. It is one of the methods used to distinguish healthy older individuals from those with cognitive impairment based on its 3 mm vertex criterion and parallel line errors. We sought to assess how: (1) precisely elderly communitydwelling individuals draw cubes based on two different vertex criteria; and(2) they keep the parallelism of lines. Methods: The cross-sectional design study population comprised 121 adults ((outlier analysis excluded the results of three, resulting in 118 participants) ≥ 65 years (21 men and 100 women) who participated in an annual physical fitness circuit and who lived independently in their communities. We recorded the participants' ages, years of education, and the scores they obtained in the Japanese version of the Montreal Cognitive Assessment. Participants were instructed to draw the cube as precisely as possible. Cube drawings were assessed based on the correct position of the vertices using 1 and 3 mm criteria and parallel line errors. Results: Eighty-nine percent of the participants were able to draw vertices within 3 mm distance from the correct position but found it difficult to draw them within 1 mm distance. Using the 3 mm vertex criterion, the mean score for correct vertices was six (out of a maximum of eight). Most of the participants made a maximum of one out of six possible parallel line errors. Conclusions: Almost 90% of the elderly in our study drew the vertices within 3 mm of the correct position, and the parallel line errors were few. The 3 mm vertex and parallel line criteria by cube-copying seem to be cleared by most community-dwelling elderly. Further research should determine if participants aged ≥85 years with less than 6 years of education show different results.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Assessment of cube‐copying among community‐dwelling elderly living in Japan using the vertex criterion and parallelism

2021

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“…For the CC item, Oonuma et al [ 54 ] reported that 31.1% of individuals with normal cognition failed to complete the test correctly. The difficult level revealed for the single CC item in this study suggested that 37% (306/827) of the participants failed to complete the task.…”

Section: Discussionmentioning

confidence: 99%

An Effective Test (EOmciSS) for Screening Older Adults With Mild Cognitive Impairment in a Community Setting: Development and Validation Study

Chan¹,

Lee²,

Chen³

et al. 2023

J Med Internet Res

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Background Early detection of mild cognitive impairment (MCI) symptoms is an important step to its diagnosis and intervention. We developed a new screening test called “Efficient Online MCI Screening System” (EOmciSS) for use in community-dwelling older adults. It is a self-paced cognitive test to be completed within 10 minutes on tablets or smartphones in homes or care centers for older adults. Objective This study aims to test the validity of EOmciSS for identifying community-dwelling older adults with MCI risks. Methods Participants (N=827) completed EOmciSS and other screening tests for MCI. The psychometric properties tested were “subscale item difficulty,” “discriminative index,” “internal consistency,” and “construct validity.” We also tested between-group discrimination using the cross-validation method in an MCI group and a normal cognitive function (NCF) group. Results A total of 3 accuracy factors and 1 reaction time factor explained the structure of the 20 item factors. The difficulty level of accuracy factors (ie, “trail making,” “clock drawing,” “cube copying,” “delayed recall”) was 0.63-0.99, whereas that of the reaction time factor was 0.77-0.95. The discriminative index of the medium-to-high-difficulty item factors was 0.39-0.97. The internal consistency (Cronbach α) ranged from .41 (for few item factors) to .96. The training data set contained 9 item factors (CC-Acc1, P<.001; CD-Acc1, P=.07; CD-Acc2, P=.06; CD-Acc3, P<.001; TM-Acc4, P=.07; DR-Acc1, P=.03; RS, P=.06; DR-RT1, P=.02; and DR-RT2, P=.05) that were significant predictors for an MCI classification versus NCF classification. Depressive symptoms were identified as significant factors (P<.001) influencing the performance of participants, and were an integral part of our test system. Age (P=.15), number of years of education (P=.18), and proficiency in using an electronic device (P=.39) did not significantly influence the scores nor classification of participants. Application of the MCI/NCF cutoff score (7.90 out of 9.67) to the validation data set yielded an area under the curve of 0.912 (P<.001; 95% CI 0.868-0.955). The sensitivity was 84.9%, specificity was 85.1%, and the Youden index was 0.70. Conclusions EOmciSS was valid and reliable for identifying older adults with significant risks of MCI. Our results indicate that EOmciSS has higher sensitivity and specificity than those of the Computer-Administered Neuropsychological Screen for Mild Cognitive Impairment and the Computerized Cognitive Screen. The user interface, online operation, and self-paced format allowed the test system to be operated by older adults or their caregivers in different settings (eg, home or care centers for older adults). Depressive symptoms should be an integral part in future MCI screening systems because they influence the test performance and, hence, MCI risk. Trial Registration Chinese Clinical Trial Registry ChiCTR2000039411; http://www.chictr.org.cn/showprojen.aspx?proj=62903

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Necker cube copying may not be appropriate as an examination of dementia: reanalysis from the Tajiri Project

Abstract: Our results suggested that Necker cube copying may evaluate visual illusion as well as visuoconstructional ability. The Necker cube may not be an appropriate test to detect participants with MCI due to dementia.

Cited by 2 publications

References 30 publications

Assessment of cube‐copying among community‐dwelling elderly living in Japan using the vertex criterion and parallelism

Assessment of cube‐copying among community‐dwelling elderly living in Japan using the vertex criterion and parallelism

An Effective Test (EOmciSS) for Screening Older Adults With Mild Cognitive Impairment in a Community Setting: Development and Validation Study

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