Clock Completion: An Objective Screening Test for Dementia

Watson, Yasmira I.; Arfken, Cynthia L.; Birge, Stanley J.

doi:10.1111/j.1532-5415.1993.tb07308.x

Cited by 302 publications

(242 citation statements)

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“…Secondary efficacy outcomes were 24-week scores on the Alzheimer's Disease Cooperative Study--Activities of Daily Living (ADCS-ADL) scale (Galasko et al, 1997); Neuropsychiatric Inventory (NPI) for behavior and psychiatric symptoms (Cummings et al, 1994); MMSE (Folstein et al, 1975) for cognition; Ten Point Clock-drawing Test (Watson et al, 1993) for assessment of visuospatial and executive functions and the Trail Making Test Part A for assessment of attention, visual tracking and motor processing speed (Reitan, 1958;Corrigan and Hinkeldey, 1987).…”

Section: Discussionmentioning

confidence: 99%

A six‐month double‐blind, randomized, placebo‐controlled study of a transdermal patch in Alzheimer's disease–– rivastigmine patch versus capsule

Winblad

Cummings

Andreasen

et al. 2007

Int J Geriat Psychiatry

261

312

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ObjectivesTo compare the efficacy, safety and tolerability of a novel rivastigmine transdermal patch with conventional rivastigmine capsules and placebo in patients with Alzheimer's disease (AD).MethodsIn this 24‐week, multicenter, double‐blind, double‐dummy, placebo‐ and active‐controlled trial, patients with probable AD were randomized to one of four treatment groups: 12 mg/day rivastigmine capsules; 10 cm2 (9.5 mg/24 h) rivastigmine patch; 20 cm2 (17.4 mg/24 h) rivastigmine patch; or placebo. Primary efficacy measures were the Alzheimer's Disease Assessment Scale—Cognitive subscale (ADAS‐Cog) and Alzheimer's Disease Cooperative Study––Clinical Global Impression of Change (ADCS‐CGIC).ResultsOne thousand one hundred and ninety five AD patients from 21 countries participated in the study. Treatment differences (vs placebo) on the ADAS‐Cog at Week 24 in 10 cm2 patch, 20 cm2 patch and capsule groups were 1.6 (p = 0.005), 2.6 (p < 0.001) and 1.6 (p = 0.003). Treatment differences on the ADCS‐CGIC were 0.3 (p = 0.01), 0.2 (p = 0.054) and 0.3 (p = 0.009). Comparison between the 10 cm2 patch and the capsule revealed non‐inferiority. Rates of nausea in the 10 cm2 patch and capsule groups were 7.2% and 23.1%, respectively; rates of vomiting were 6.2% and 17.0%, respectively. Moderate or severe skin irritation occurred in ≤10% patients across the four patch sizes (5, 10, 15 and 20 cm2).ConclusionsThe target dose of 10 cm2 rivastigmine patch provides efficacy similar to the highest doses of capsules with a superior tolerability profile. The transdermal patch with rivastigmine may offer convenience important to many caregivers and patients. Copyright © 2007 John Wiley & Sons, Ltd.

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Section: Discussionmentioning

confidence: 99%

A six‐month double‐blind, randomized, placebo‐controlled study of a transdermal patch in Alzheimer's disease–– rivastigmine patch versus capsule

Winblad

Cummings

Andreasen

et al. 2007

Int J Geriat Psychiatry

261

312

View full text Add to dashboard Cite

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“…Stuss states that cognitive screening tests must be formally compared to effectively choose between them (16). (Various studies that have done this [16][17][18] favour comparisons using receiver-operating characteristics [ROC], because these are better measures of performance when cut-off points are not standard or do not apply to a given sample. )…”

Section: Conceptual and Methodological Issues In Evaluating Screeningmentioning

confidence: 99%

Brief Screening Tests for Dementia

2002

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Objective: To compare brief dementia screening tests as candidates for routine use in primary care practice. Method:We selected screening tests that met 2 criteria: 1) administration time of 10 minutes or less in studies including individuals with, and without, dementia; and 2) performance characteristics evaluated in at least 1 community or clinical sample of older adults. We compared tests for face validity, sensitivity, and specificity in a clearly defined subject sample; for vulnerability to sociodemographic biases unrelated to dementia; for direct comparison with an accepted standard; for acceptability to patients and doctors; and for brevity and ease of administration, scoring, and interpretation by nonspecialists.Results: Thirteen instruments met our inclusion criteria. Very short tests (1 minute or less) proved unacceptable by several criteria. Standard instruments requiring more than 5 minutes to complete, including the best-studied Mini-Mental State Examination (MMSE), were found to be too long for routine application. Several failed other performance tests or could not be adequately assessed. Short tests taking between 2 and 5 minutes that can be administered by nonspecialists with little or no training and are relatively unbiased by language and education level appear to be superior to both shorter and longer instruments. Conclusions:Three tests showed the most promise for broad application in primary care settings: the Mini-Cog, the Memory Impairment Screen, and the General Practitioner Assessment of Cognition (GPCOG). Formal practice intervention trials are now needed to validate the utility of short screens with regard to implementation, effect on rates of diagnosis and treatment of dementia patients, and outcomes for patients, families, and health care systems. Clinical Implications · Methods currently exist that can likely improve recognition of dementia in elderly primary care patients. · No single dementia screening tool has been shown to pass all the relevant performance tests needed to include it in a guideline-level recommendation. · Not all screening methods are equal, and care must be used in interpreting the results of published studies. Proof of the value of widespread screening must be established by health services intervention trials in primary care practices. Limitations· We included only papers published in English. · We did not explicitly consider application costs. · We make no recommendations regarding practical responses to false-positive and falsenegative screens.

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“…However, as the MMSE is insensitive to subtle cognitive impairment and is weak on visuo spatial testing, it may be appropriate to augment it with the 'drawaclock task' (Watson et al, 1993).…”

Section: Screening For Cognitive Dysfunctionmentioning

confidence: 99%

Alcohol use disorders in elderly people: fact or fiction?

Dar¹

2006

Adv. psychiatr. treat

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). His clinical responsibilities include the Max Glatt Unit (a regional inpatient detoxification unit attached to the hospital) and a community alcohol team. His special interests include substance misuse problems in special populations and the economics of service provision. AbstractThe number of older people is increasing in populations throughout the world. Alcohol use disorders in elderly people are a common but underrecognised problem associated with major physical and psychological health problems. Owing to the negative attitudes and inadequate training of healthcare professionals, alcohol misuse is not always being detected or effectively treated. Current diagnostic criteria and common screening instruments for alcohol use disorders may not be appropriate for elderly people. Older people are as likely to benefit from treatment as younger people and the basic principles of treatment are much the same. Better integrated and outreach services are needed. Training of healthcare professionals in this area and pragmatic research should be prioritised to improve detection, treatment and service provision for this vulnerable and neglected population.

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Clock Completion: An Objective Screening Test for Dementia

Abstract: A simple, completely objective scoring system for a clock completion test has been developed which involves only the number of digits placed in the fourth quadrant of a pre-drawn circle. This readily administered test is as effective in screening for dementia as the longer six-item SBT.

Cited by 302 publications

References 20 publications

A six‐month double‐blind, randomized, placebo‐controlled study of a transdermal patch in Alzheimer's disease–– rivastigmine patch versus capsule

A six‐month double‐blind, randomized, placebo‐controlled study of a transdermal patch in Alzheimer's disease–– rivastigmine patch versus capsule

Brief Screening Tests for Dementia

Alcohol use disorders in elderly people: fact or fiction?

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