The Clock Drawing Test as a Valid Screening Method for Mild Cognitive Impairment

Yamamoto, Sayaka; Mogi, Nanaka; Umegaki, Hiroyuki; Suzuki, Yusuke; Ando, Fujiko; Shimokata, Hiroshi; Iguchi, Akihisa

doi:10.1159/000079198

Cited by 100 publications

(96 citation statements)

References 20 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 89%

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

Lessig

Scanlan

Nazemi

et al. 2007

IPG

View full text Add to dashboard Cite

show abstract

“…Most tasks use a pre-drawn circle of 3-4 inches in diameter and some include having the subject place the 'hands' of the clock to a set time. Despite these differences and the more than a dozen scoring systems, correlations among the systems (0.42-0.98) [15,16] State Examination and other cognitive tests are high (generally 1 0.5) [14] . While the reported sensitivity and specificity for discriminating individuals with dementia and related disorders from normal subjects are high [8,14,17] (mean of 85% for published studies [14] ), the utility of the test in general geriatric outpatient clinics is probably more modest [18] .…”

Section: Discussionmentioning

confidence: 99%

Preliminary Assessment of Cognitive Function in Older Adults by Clock Drawing, Box Copying and Narrative Writing

Paganini‐Hill

Clark

2006

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

Objective: To examine 3 cognitive screening tasks in older adults and determine which demographic, medical and lifestyle variables obtained 13–17 years previously predicted cognitive performance. Design: Population-based longitudinal cohort study begun in 1981. Setting: Leisure World Laguna Hills, a California retirement community. Participants: The cohort is predominantly white, well educated, upper-middle class; two thirds are women. Data from 1,744 participants (mean age 83 years, range 57–103) were analyzed. Measurements: The baseline postal survey (1981–1985) asked demographic information, medical history, selected drug use and personal habits. The 1998 follow-up included 3 tasks to assess cognitive function: (1) clock drawing, (2) copying a box drawing and (3) narrative writing to describe a pictured scene. Results: Within age groups, women tended to have lower scores than men on box copying, similar scores on clock drawing, but higher informational and complexity scores on narrative writing. Performance decreased with increasing age and was poorest in individuals ≧90 years old. In addition to age, sex and education, significant predictors of performance were: exercise, body mass index and cataract surgery (clock); vitamin E supplements, daily aspirin use and gallbladder surgery (box); vitamin A supplements (narrative writing). Mean scores on all tasks were lower in those later identified as demented compared with nondemented but significantly different only for clock and box drawings. Conclusion: Performance on 3 cognitive tests showed significant effects of age, sex and education and was related to later dementia. Better performance by users of antioxidant supplements and aspirin suggests that these drugs may maintain cognitive function in later life.

show abstract

“…To do this, we ran a PubMed search for MCI or cognitive impairment no dementia to identify and review all articles published on or before November 30, 2004, which studied normal aging vs. MCI and published sensitivity, specificity, and sample size (14,(23)(24)(25)(26)(27)(28)(29). Studies were excluded if they did not report these values for a normal-aging vs. MCI sample or included subjects with MD or moderate dementia because they would spuriously raise sensitivity.…”

Section: Methodsmentioning

confidence: 99%

Methods to improve the detection of mild cognitive impairment

Shankle

Romney

Hara

et al. 2005

Proc. Natl. Acad. Sci. U.S.A.

131

View full text Add to dashboard Cite

We examined whether the performance of the National Institute of Aging's Consortium to Establish a Registry for Alzheimer's Disease's 10-word list (CWL), part of the consortium's neuropsychological battery, can be improved for detecting Alzheimer's disease and related disorders early. We focused on mild cognitive impairment (MCI) and mild dementia because these stages often go undetected, and their detection is important for treatment. Using standardized diagnostic criteria combined with history, physical examination, and cognitive, laboratory, and neuroimaging studies, we staged 471 community-dwelling subjects for dementia severity by using the Clinical Dementia Rating Scale. We then used correspondence analysis (CA) to derive a weighted score for each subject from their item responses over the three immediate-and one delayed-recall trials of the CWL. These CA-weighted scores were used with logistic regression to predict each subject's probability of impairment, and receiver operating characteristic analysis was used to measure accuracy. For MCI vs. normal, accuracy was 97% [confidence interval (C.I.) 97-98%], sensitivity was 94% (C.I. 93-95%), and specificity was 89% (C.I. 88 -91%). For MCI͞mild dementia vs. normal, accuracy was 98% (C.I. 98 -99%), sensitivity was 96% (C.I. 95-97%), and specificity was 91% (C.I. 89 -93%). MCI sensitivity was 12% higher (without lowering specificity) than that obtained with the delayed-recall total score (the standard method for CWL interpretation). Optimal positive and negative predictive values were 100% and at least 96.6%. These results show that CA-weighted scores can significantly improve early detection of Alzheimer's disease and related disorders.

show abstract

The Clock Drawing Test as a Valid Screening Method for Mild Cognitive Impairment

Cited by 100 publications

References 20 publications

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

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

Preliminary Assessment of Cognitive Function in Older Adults by Clock Drawing, Box Copying and Narrative Writing

Methods to improve the detection of mild cognitive impairment

Contact Info

Product

Resources

About