Longitudinal Assessment of Cognitive Function by Clock Drawing in Older Adults

Paganini‐Hill, Annlia; Clark, Linda J.

doi:10.1159/000326781

Cited by 16 publications

(19 citation statements)

References 54 publications

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“…Studies in older community dwellers with up to 7 years of follow-up consistently report the CDT as a predictor of all-cause mortality risk independently of health confounders [30,31,32,33]. By contrast, the only evidence for CDT as a predictor of nonlethal outcomes in older persons included residents from a retirement community, and an association with the 2.5-year risk of needing 24-hour care was found [31].…”

Section: Discussionmentioning

confidence: 99%

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Combination of the Clock Drawing Test with the Physical Phenotype of Frailty for the Prediction of Mortality and Other Adverse Outcomes in Older Community Dwellers without Dementia

Forti

Maioli²,

Lega³

et al. 2013

Gerontology

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Background: Cognitive assessment is thought to increase the ability of the physical phenotype of frailty to identify older persons at a higher risk for adverse outcomes. Objective: Data from a cohort of dementia-free community dwellers were used to investigate whether the clock drawing test (CDT), a quick and easy cognitive screening test, is associated with adverse health outcomes independently of the physical phenotype of frailty. Methods: Thiswas a prospective population-based cohort study of 766 dementia-free Italian community dwellers aged 65 years or older. Baseline assessment included the physical phenotype of frailty, 3 different CDT protocols [Sunderland, Shulman, and the clock drawing interpretation scale (CDIS)], and several health confounders. Hazard ratios (HR) and odds ratio (OR) along with their corresponding 95% confidence intervals (CI) from models adjusted for frailty and sociodemographic and health confounders were used to estimate the independent association of the CDT with the 7-year risk of all-cause mortality and the 3-year risk of new and worsening disability, hospitalization, and fractures. Results: After adjustment for confounders, the Sunderland CDT was significantly associated with all-cause mortality independently of the physical phenotype of frailty (HR = 1.44, 95% CI 1.03-2.01, p = 0.031). However, compared to all nonfrail participants with a normal Sunderland CDT, the HR was 1.57 (95% CI 1.09-2.26, p = 0.016) for those with impairment on the Sunderland CDT only, 2.48 (95% CI 1.46-4.20, p = 0.001) for those with frailty only, and 2.52 (95% CI 1.34-4.77, p = 0.004) for those with both frailty and impairment on the Sunderland CDT. Mortality was unrelated to the CDIS CDT (p = 0.359) and the Shulman CDT (p = 0.281). No statistically significant relationship was found between nonlethal outcomes and any CDT protocol, although trends were found for an association of both the Sunderland CDT (p = 0.118) and the CDIS CDT with worsening disability (p = 0.154). Conclusions: In older persons, depending on the scoring system, the CDT may predict the mortality risk independently of the physical phenotype of frailty. However, combining the two measurements does not improve their individual prognostic abilities.

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Section: Discussionmentioning

confidence: 99%

“…None of these investigations, however, included assessment of the physical phenotype. Moreover, most of them used nonstandard CDT protocols with no predefined standard cutoffs [30,31,33]. One study [32] used Royall's CLOX, which is reported to have the highest sensitivity for executive impairment [13].…”

Section: Discussionmentioning

confidence: 99%

Combination of the Clock Drawing Test with the Physical Phenotype of Frailty for the Prediction of Mortality and Other Adverse Outcomes in Older Community Dwellers without Dementia

Forti

Maioli²,

Lega³

et al. 2013

Gerontology

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“…CDT is a neuropsychological tool to assess a wide range of higher-level cognitive abilities required simultaneously for its successful completion, including language comprehension, visuospatial abilities, working memory, attention and abstract thinking 27. CDT is a useful instrument to identify subjects at risk of cognitive decline and dementia 28. We used a validated Spanish version ranging from 0 to 7 29…”

Section: Methodsmentioning

confidence: 99%

Mediterranean diet improves cognition: the PREDIMED-NAVARRA randomised trial

Martínez-Lapiscina

Clavero

Toledo

et al. 2013

J Neurol Neurosurg Psychiatry

571

379

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“…We used a validated Spanish version ranging from 0 to 7 (del Ser Quijano et al 2004). Both cognitive tests are valid indicators of cognitive impairment (Crook et al 1986;Paganini-Hill and Clark 2011). Researchers who assessed the outcome were blinded to group assignment.…”

Section: Cognitive Assessmentmentioning

confidence: 99%

Genotype patterns at CLU, CR1, PICALM and APOE, cognition and Mediterranean diet: the PREDIMED-NAVARRA trial

et al. 2014

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The traditional Mediterranean diet (MedDiet) has shown beneficial effects on cognitive decline. Nevertheless, diet-gene interactions have been poorly evaluated. We aimed to investigate diet-gene interaction in the PREDIMED-NAVARRA randomized trial. A total of 522 participants (67 ± 6 years at baseline) enrolled in the PREDIMED-NAVARRA trial were randomly allocated to one of three diets: two MedDiets (supplemented with either extra-virgin olive oil or nuts) or a low-fat diet. They were evaluated with the Mini-Mental State Examination (MMSE) and the Clock Drawing Test (CDT) after 6.5 years of intervention. Subjects were genotyped for CR1-rs3818361, CLU-rs11136000, PICALM-rs3851179 and Apolipoprotein E (ApoE) genes. We studied MedDietgene interactions for cognition and assessed the effect of the MedDiet on cognition across different genetic profiles. A significant interaction (p = 0.041) between CLUrs11136000 and the MedDiet intervention on the MMSE was found with a beneficial effect of MedDiet among carriers of the T minor allele (B = 0.97, 95 % CI 0.45-1.49). Similar effect was observed for CR1-rs3818361, but no significant interaction was observed (p = 0.335). For PICALM-rs3851179, the MedDiet intervention showed a beneficial effect in both genotype groups. No apparent interaction was found for the CDT between intervention and gene variants. Similarly, participants randomly allocated to MedDiet groups, with favorable 123Genes Nutr (2014) 9:393 DOI 10.1007/s12263-014-0393-7 profiles of CR1, CLU and PICALM genes, significantly improved CDT scores compared to controls with the same genetic profile. Cognitive performance was better for nonApoE4 and for ApoE4 carriers of MedDiet groups compared to controls, but for CDT performance, we only found statistical significant differences for non-ApoE4 carriers. A MedDiet intervention modulates the effect of genetic factors on cognition. The effect of MedDiet might be greater for subjects with a more favorable genetic profile.

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Longitudinal Assessment of Cognitive Function by Clock Drawing in Older Adults

Cited by 16 publications

References 54 publications

Combination of the Clock Drawing Test with the Physical Phenotype of Frailty for the Prediction of Mortality and Other Adverse Outcomes in Older Community Dwellers without Dementia

Combination of the Clock Drawing Test with the Physical Phenotype of Frailty for the Prediction of Mortality and Other Adverse Outcomes in Older Community Dwellers without Dementia

Mediterranean diet improves cognition: the PREDIMED-NAVARRA randomised trial

Genotype patterns at CLU, CR1, PICALM and APOE, cognition and Mediterranean diet: the PREDIMED-NAVARRA trial

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