The clock drawing test is a poor screen for very mild dementia

Powlishta, Kimberly K.; Dras, Dean D. Von; Stanford, Amy H.; Carr, David B.; Tsering, C.; Miller, J. Phillip; Morris, John C.

doi:10.1212/wnl.59.6.898

Cited by 110 publications

(105 citation statements)

References 44 publications

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“…In most of the former studies, the cutoff points of CDTs were provided with the aim of distinguishing a demented state or AD from normal cognition. Recently, Powlishta et al [16], choosing 6 different scoring criteria of the CDT for comparing subjects without altering the cutoff points determined for dementia in each original CDT criterion, have reported that the CDT was a poor screening method for very mild dementia. The sensitivity and specificity for detecting MCI by the CDT obtained in the current study were satisfactory.…”

Section: Discussionmentioning

confidence: 99%

“…To date, there has been a dearth of studies examining the utility of the CDT in detecting cognitive deficits in their early stages, in particular MCI. Previous studies yielded conflicting results with limitations in terms of the criteria used for group assignment, the sample size, and the optimal cutoff points for different types of cognitive status [15,16]. Besides, most previous studies emphasized the use of quantitative analyses of the CDT results, leaving detailed qualitative analyses of the results somewhat neglected.…”

Section: Introductionmentioning

confidence: 99%

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

Yamamoto

Mogi

Umegaki

et al. 2004

Dement Geriatr Cogn Disord

102

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To validate the Clock Drawing Test (CDT) as a screening method for detecting mild cognitive impairment (MCI) and to find the appropriate scoring protocol and its cutoff point, we compared the sensitivity and specificity of three CDT protocols. Subjects included 219 outpatients with memory complaints, who were attending the geriatric memory clinic. Cahn’s protocol, with a cutoff point of 7, was more successful at differentiating clinically diagnosed MCI subjects from normal elderly individuals, with higher sensitivity (74.7%) and specificity (75.6%), than were the other protocols. The CDT, as a handy screening method, may be useful for clinicians to reliably identify subjects with MCI, and it may contribute to early detection of dementia.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Yamamoto

Mogi

Umegaki

et al. 2004

Dement Geriatr Cogn Disord

102

View full text Add to dashboard Cite

show abstract

“…The CDT was used to screen for visuospatial and visuoconstructive disabilities. Two independent scoring systems, the Watson scoring system [39,40] and the AD Cooperative Study scoring system [41], were both adopted to measure the performance of each subject. Given the motor dysfunctions observed in the SCA3 patients, the time taken to complete the drawing task was not included.…”

Section: Methodsmentioning

confidence: 99%

Cognitive Impairment in Native Chinese with Spinocerebellar Ataxia Type 3

Chen

Hou

et al. 2014

Eur Neurol

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Background: Previous studies have shown cognitive impairment in patients with spinocerebellar ataxia type 3 (SCA3). However, there is a lack of data on Chinese patients with SCA3. Method: We investigated 22 native Chinese with SCA3 and 18 controls matched for age, education as well as mental status. Cognitive assessments were carefully carried out to measure verbal fluency, memory, attention, executive function, visuospatial and visuoconstructive functions. Results: The most common impairments of cognition in native Chinese with SCA3 were disruption of phonemic verbal fluency and frontal executive dysfunction. Deficits in semantic fluency were detected in about 31.8% patients. Impaired visuospatial function and verbal memory were also found in native Chinese with SCA3. The degree of ataxia, CAG repeat length and education were found to correlate with cognitive performance. Multivariate binary logistic regression suggested that an oculomotor disorder and depression are predictors of cognitive impairment. Conclusion: Native Chinese with SCA3 had cognitive impairment of frontal executive function, temporal and parietal functions. An oculomotor disorder might be an index of cognitive dysfunction.

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“…Both tests are quick and easy to administer (are paper-andpencil tests) and are recommended by the American Medical Association (AMA) for screening unsafe drivers. However, studies [36,42] have shown the clock drawing test not to be a good screening instrument for detecting the very earliest signs of dementia. One potential draw-back of especially using the trail test for such predictive purposes is that a candidate could get hold of a standard testing sheet and through practice acquaint himself with the spatial configuration of letters and alphabets which would allow him to get a higher but biased score.…”

Section: Discussion On Resultsmentioning

confidence: 99%

The use of neuropsychological tests to study the effects of aging on driving performance in the UK

Khan

Alam

2018

Eur. Transp. Res. Rev.

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Research was conducted to identify a series of neuropsychological tests to assess the ability to drive. Driving performance of young and old UK drivers was modeled through multiple linear regression and univariate logistic regression tools. The UFOV3 test (i.e. the third subtest of the UFOV test) had comparatively high discriminating ability in separating poor-drivers from notpoor-drivers, with 92.86% of the drivers correctly classified; the UFOV3 test resulted in a Sensitivity of 62.5%. Age and a composite cognitive measure were also found to be sound discriminators of poor-drivers and not-poor-drivers with 91.07% and 89.28% of the drivers correctly classified respectively; both age and the composite cognitive measure resulted in a Sensitivity of 50%. It was found that the commonly recommended Clock Drawing Test and the Trail Making-B test were insignificant predictors of driving ability. Results suggest that for a score greater than 220 on the UFOV3 test, the driver may be further evaluated by a driving specialist to ascertain questionable driving behavior. Also, drivers above the age of 77 were more susceptible to exhibiting unusual driving behavior; if such drivers have UFOV3 scores greater than 220 it would be more appropriate to evaluate driving behavior through a driving specialist.

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The clock drawing test is a poor screen for very mild dementia

Abstract: Although the clock drawing test can be scored reliably and can differentiate cognitively normal older adults from those with at least mild dementia of the Alzheimer type, it does not appear to be a useful screening instrument for detecting very mild dementia.

Cited by 110 publications

References 44 publications

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

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

Cognitive Impairment in Native Chinese with Spinocerebellar Ataxia Type 3

The use of neuropsychological tests to study the effects of aging on driving performance in the UK

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