The Clock Drawing Test—Modified and Integrated Approach (CDT-MIA) as an Instrument for Detecting Mild Cognitive Impairment in a Specialized Outpatient Setting

Abstract

This study examined the accuracy of the Clock Drawing Test--Modified and Integrated Approach (CDT-MIA) alone and combined with the Mini-Mental State Examination (MMSE) to detect Mild Cognitive Impairment (MCI) in patients with suspected MCI. For comparison, the accuracy of the Cambridge Cognitive Examination-Revised (CAMCOG-R) was tested. A total of 65 elderly outpatients with suspected MCI underwent a comprehensive evaluation. Following assessment, the entire sample was classified into: dementia (mild)--24 participants, MCI--22 participants, no cognitive impairment (NCI)--19 participants. CDT-MIA and the MMSE alone failed to appropriately discriminate demented from nondemented (MCI and NCI) and MCI from NCI. The best acceptable diagnostic accuracy to discriminate between demented and nondemented was obtained with CDT-MIA/MMSE combined and with CAMCOG-R. CDT-MIA/MMSE combined failed to appropriately discriminate MCI from NCI. The best diagnostic accuracy in this regard was obtained with CAMCOG-R.

Validity and Clinical Utility of Different Clock Drawing Test Scoring Systems in Multiple Forms of Dementia

“…9 Now we are further interested in exploring the use of the CDT in different clinical groups, such as MCI, AD, frontotemporal dementia (FTD), stroke/ vascular cognitive impairment, or Parkinson disease, expanding the knowledge brought by other international studies. 3,[10][11][12][13][14][15][16][17][18][19] We present a large validation study of the CDT in the most common cognitive impairment-related pathologies observed in memory clinics and/or dementia consults: AD, behavioral variant FTD, vascular dementia (VaD), dementia with Lewy bodies (DLB), and Parkinson disease with dementia (PDD).…”

Impaired abstract thinking may discriminate between normal aging and vascular mild cognitive impairment

“…Presently, the diagnosis of mild cognitive impairment (MCI) requires improvement in the sensitivity of conventional screening tests for dementia, since the rate of false-negative results is usually high for those individuals 6,7 . Studies attempting to increase such sensitivity have shown that a combination of different screening tests provides higher diagnostic accuracy compared to each test individually 8,9 . Diniz et al 7 analyzed Mini-Mental State Examination (MMSE) subtests in a sample of MCI subjects and managed to identify distinct profiles of cognitive deficits among the MCI subtypes.…”

An investigation of the efficiency of the mini-Kingston standardized cognitive assessment-revised in classifying patients according to DSM-5 major and mild neurocognitive disorders due to possible Alzheimer's disease

“…In addition, a meta-analysis found that the MMSE had a pooled sensitivity of 80% in memory clinics (Mitchell, 2009). Research with the CDT suggested that its role as a single test in the early diagnosis of cognitive impairment is controversial (Heinik et al, 2009;Lonie et al, 2009;Velayudhan et al, 2014).…”

“…The entire procedure was completed within 8-10 weeks. In all cases, the functional assessment was independent of the cognitive assessment (see Heinik et al, 2004 as well as Heinik and Shaikewitz, 2009 for details of the full procedure). Basic requirements for KSCA-R and CAMCOG-R administration consisted of Hebrew proficiency, no significant sensory (sight, hearing) or motor difficulties, as well as no severe psychiatric or physical conditions that could interfere with testing.…”