Validación de la prueba de dibujo del reloj - versión de Manos - como prueba de cribado para detectar demencia en una población adulta mayor de Lima, Perú

Abstract

Introducción. La prueba de dibujo del reloj versión de Manos (PDR-M) es un instrumento de evaluación cognitiva breve para la detección de demencia. Objetivos. Evaluar la validez y confiabilidad de la PDR-M para discriminar entre pacientes con demencia y sujetos controles sanos. Materiales y métodos. Se evaluaron sujetos mayores de 65 años de edad, excluyendo los que presentaban enfermedades concomitantes graves y con dificultades auditivas o visuales. Se recogieron datos demográficos y se les realizó PDR-M y Mini Mental State Examination (MMSE). A los individuos del grupo de demencia se les realizó además evaluaciones clínicas, de laboratorio, neuropsicológicas y tomografía cerebral. Se calculó la sensibilidad y especificidad de la PDR-M así como el área bajo la curva ROC. Resultados. Se evaluó 210 individuos, 103 con diagnóstico confirmado de demencia y 107 controles sanos, con edad y sexo similares en ambos grupos; y mayor nivel educativo en el grupo control. Estableciendo un punto de corte de 7 se obtuvo una sensibilidad de 99,0% y una especificidad de 83,5%. Cuando se compararon las áreas bajo la curva ROC de la PDR-M y del MMSE no se encontraron diferencias significativas. Conclusiones. La PDR-M es un instrumento breve y confiable para la detección de demencia en la población urbana de Lima en el Perú. VALIDATION OF THE CLOCK DRAWING TEST -MANOS´ VERSION -AS A SCREENING TEST FOR DETECTION OF DEMENTIA IN OLDER PERSONS OF LIMA; PERU ABSTRACT Introduction. The clock drawing test (PDR-M) -Manos´ version -is a brief cognitive assessment tool for dementia detection.Objectives. To assess the validity and reliability of the PDR-M to discriminate between patients with dementia and healthy control subjects. Materials and methods. We evaluated subjects over 65 years of age, excluding those with severe concomitant diseases and those with hearing or visual impairment. We obtained demographic data and performed the PDR-M and Mini Mental State Examination (MMSE). Subjects of the dementia group were also submitted to clinical, laboratory and neuropsychological evaluations as well as computed tomography scanning. Sensitivity and specificity of the PDR-M were calculated as well as the area under the ROC curve. Results. We evaluated 210 individuals, 103 with confirmed diagnosis of dementia and 107 healthy controls with similar age and sex in both groups, but a higher educational level in the control group. Setting a cutoff point of 7, a sensitivity of 99.0% and a specificity of 83.5% were found. When comparing the areas under the ROC curves of the PDR-M and MMSE we found no statistically significant difference. Conclusions. The PDR-M is a brief and reliable instrument for the detection of dementia in the urban population of Lima, Peru.

Evaluation of the INECO Frontal Screening and the Frontal Assessment Battery in Peruvian patients with Alzheimer's disease and behavioral variant Frontotemporal dementia

“…The subjects underwent a standard examination battery including the following successive evaluations: 1) screening; 2) dementia diagnosis; and 3) dementia sub-type diagnosis. In the screening phase, the evaluators applied the Mini Mental State Examination (MMSE) [15] , the clock drawing test – Mano's version (CDT-Mv) [16] and the Pfeffer Functional Activities Questionnaire (PFAQ) [17] . Those patients with at least one positive test for dementia were submitted to the second evaluation (applied by a second evaluator) with MMSE and CDT-Mv.…”

Systematic Review of the Diagnostic Validity of Brief Cognitive Screenings for Early Dementia Detection in Spanish-Speaking Adults in Latin America

“…three for not reporting diagnostic accuracy measures (Rosselli et al, 2000;Labos et al, 2008;Pedraza et al, 2014); four for reporting only one diagnostic accuracy measure (Ostrosky-Solís et al, 2000;Quiroga et al, 2004;Franco-Marina et al, 2010;Oscanoa et al, 2016); and one for including patients with depression in the sample (Fiorentino et al, 2013). After applying the MTRQ/MCAR to the 14 remaining publications, a study validating the Manos version of the clock-drawing test was also excluded (Custodio et al, 2011) as the translation and cultural adaptation process was not described. Finally, 13 publications were selected for the definitive analysis (see the description in Table 2), five of which evaluated the MoCA (Pereira-Manrique and Reyes, 2013; Pedraza et al, 2016;Aguilar-Navarro et al, 2017;Delgado et al, 2017), three the IFS (Torralva et al, 2009;Ihnen Jory et al, 2013;Custodio et al, 2016), two the M@T (Custodio et al, 2014(Custodio et al, , 2017a, and one the memory, fluency, and orientation (MEFO) test (Delgado Derio et al, 2013); the Phototest (Russo et al, 2014) and the last one, about Memory Binding Test (MBT) (Roman et al, 2016).…”

Validity of Addenbrooke's Cognitive Examination to Discriminate between Incipient Dementia and Depression in Elderly Patients of a Private Clinic in Lima, Peru

“…CI screening was carried out by means of the application of the questionnaire for the assessment of subjective memory complaints [36], the MMSE [10] and the Clock‐Drawing Test, Manos' version [37]. The Pfeffer Functional Activities Questionnaire (PFAQ) was used for functional evaluation [38].…”