Longitudinal Analysis of Clock Drawing in Alzheimer's Disease Patients

Rouleau, Isabelle; Salmon, David P.; Butters, Nelson

doi:10.1006/brcg.1996.0022

Cited by 125 publications

(115 citation statements)

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“…We observed that CDT errors were related to dementia severity, consistent with the findings of Rouleau et al (1996) and Yamamoto et al (2004), whose sample sizes were smaller and error analyses less transparent than in the present study. We and others (Seigerschmidt et al, 2002;Powlishta et al, 2002) find that subsyndromal cognitive impairment cannot be effectively distinguished by the CDT alone, and requires different and more complex screening tests (De Jager et al, 2003).…”

Section: Discussionsupporting

confidence: 89%

Time that tells: critical clock-drawing errors for dementia screening

Lessig

Scanlan

Nazemi

et al. 2007

IPG

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Background-Clock-drawing tests are popular components of dementia screens but no single scoring system has been universally accepted. We sought to identify an optimal subset of clock errors for dementia screening and compare them with three other systems representative of the existing wide variations in approach (Shulman, Mendez, Wolf-Klein), as well as with the CDT system used in the Mini-Cog, which combines clock drawing with delayed recall.

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Section: Discussionsupporting

confidence: 89%

Time that tells: critical clock-drawing errors for dementia screening

Lessig

Scanlan

Nazemi

et al. 2007

IPG

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“…1). According to several authors [21,88,125,126,201,202], the CDT is able to distinguish different severity levels and clinical forms of dementia, but other authors reported contrasting findings with respect to both issues [65,123,128,131,158]. These deceiving results are probably due to two main factors.…”

Section: Discussionmentioning

confidence: 99%

“…1). These errors in clock drawings have been described in a small proportion of AD patients [170], but would increase in moderate to severe stages of the disease [88]. Ryan et al [171] compared graphic performances on the Bender visuomotor Gestalt test and on CDT in AD with or without wandering, and observed a larger number of both continuous and recurrent perseverative errors in individuals showing the wandering phenomenon, thus suggesting a relationship between perseveration and behavioral control.…”

Section: Graphic Perseverationmentioning

confidence: 99%

“…However, since free drawing poses a heavy load on semantic memory, errors on this task (e.g., simplifications in drawing a house) may derive from impaired access to semantic knowledge or to impaired visuoperceptual processing [51]. For this reason, spontaneous drawing could be impaired in the early stages of AD, while copying may deteriorate later [88]. The reproduction of complex figures is particularly sensitive to the progression of the disease [89].…”

Section: The Drawing Tasks Used In Ad and The Corresponding Kinds Of mentioning

confidence: 99%

“…Such behavior, termed 'closing-in' (CI), has been first described by Mayer-Gross [23], and later reported more often in demented patients than after focal brain lesions [24,90]. Among dementing syndromes, CI is predominant in AD [88,184], suggesting the idea that CI might represent a neuropsychological marker for clinical diagnosis of AD [90,185,186]. One more recent study [25] confirmed that CI is more frequent in AD with respect to VaD patients, and that the two patient groups also tended to show qualitatively different CI phenomena, as AD patients more often overlapped at least one element of the copy onto the model (adherent-CI), whereas VaD patients more often drew close to the model without overlapping onto it (near-CI).…”

Section: Closing-inmentioning

confidence: 99%

See 2 more Smart Citations

Drawing Disorders in Alzheimer’s Disease and Other Forms of Dementia

Trojano

Gainotti

2016

JAD

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Abstract. Drawing is a multicomponential process that can be impaired by many kinds of brain lesions. Drawing disorders are very common in Alzheimer's disease and other forms of dementia, and can provide clinical information for the distinction of the different dementing diseases. In our review we started from an overview of the neural and cognitive bases of drawing, and from a recollection of the drawing tasks more frequently used for assessing individuals with dementia. Then, we analyzed drawing disorders in dementia, paying special attention to those observed in Alzheimer's disease, from the prodromal stages of the amnesic mild cognitive impairment to the stages of full-blown dementia, both in the sporadic forms with late onset in the entorhino-hippocampal structures and in those with early onset in the posterior neocortical structures. We reviewed the drawing features that could differentiate Alzheimer's disease from vascular dementia and from the most frequent forms of degenerative dementia, namely frontotemporal dementia and Lewy body disease. Finally, we examined some peculiar aspects of drawing disorders in dementia, such as perseverations, rotations, and closing-in. We argue that a careful analysis of drawing errors helps to differentiate the different forms of dementia more than overall accuracy in drawing.

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