Cognitive performance of community-dwelling oldest-old individuals with major depression: the Pietà study

ABSTRACTBackground:Individuals with late-life depression (LLD) may present cognitive symptoms. We sought to determine whether a brief cognitive battery (BCB) could identify cognitive and functional deficits in oldest-old individuals with LLD and a low level of education.Methods:We evaluated 639 community-dwelling individuals aged 75+ years in Caeté (MG), Brazil. We used the MINI and GDS-15 to diagnose major depression and evaluate its severity, respectively. The cognitive evaluation comprised the Mini-Mental State Examination (MMSE), BCB, clock-drawing test, category fluency test (animals) and Pfeffer's Functional Activities Questionnaire (FAQ).Results:Fifty-four (11.6%) of the included individuals were diagnosed with LLD; on average, these participants were aged 81.0 ± 4.8 years and had 3.9 ± 3.4 years of schooling, and 77.8% of the subjects with LLD were female. Depressed individuals scored lower than subjects without dementia/depression on the MMSE overall (p < 0.001) and on several of the MMSE subscales, namely, time (p < 0.001) and spatial orientation (p = 0.021), attention/calculation (p = 0.019), and language (p = 0.004). Individuals with LLD performed worse on the incidental and (p = 0.011) immediate memory (p = 0.046) and learning tasks (p = 0.039) of the BCB. Individuals with LLD also performed worse on the category fluency test (p = 0.006), clock-drawing test (p = 0.011) and FAQ (p < 0.001). Depression severity was negatively correlated with incidental memory (ρ = −0.412; p = 0.003) and positively correlated with FAQ score (ρ = 0.308; p = 0.035). In the multiple regression analysis, only temporal orientation and FAQ score remained independently associated with LLD.Conclusion:Individuals with depression and a low level of education presented several cognitive and functional deficits. Depression severity was negatively correlated with incidental memory and functionality. Our findings serve as a description of the presence of cognitive dysfunction in individuals with LLD and suggest that these deficits may be identified based on the results of a BCB.

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Cognitive function screening of community-dwelling elderly people using the clock drawing test -quantitative and qualitative analyses

Nippon Ronen Igakkai Zasshi Japanese Journal of Geriatrics ◽

10.3143/geriatrics.49.483 ◽

2012 ◽

Vol 49 (4) ◽

pp. 483-490

Author(s):

Yoko Konagaya ◽

Tomoyuki Watanabe ◽

Masaaki Konagaya

Keyword(s):

Cognitive Function ◽

Elderly People ◽

Community Dwelling ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test ◽

Qualitative Analyses

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Is the Mini-Mental State Examination the best cognitive screening test for less educated people?

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20190043 ◽

2019 ◽

Vol 77 (5) ◽

pp. 330-334 ◽

Cited By ~ 1

Author(s):

Luis Felipe Scarabelot ◽

Mariane de Moraes Monteiro ◽

Mauren Carneiro da Silva Rubert ◽

Viviane de Hiroki Flumignan Zetola

Keyword(s):

Verbal Fluency ◽

Mini Mental State Examination ◽

Recall Test ◽

Cognitive Screening ◽

Delayed Recall ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test ◽

State Examination ◽

Fluency Test

ABSTRACT Mini-Mental State Examination (MMSE) results are strongly influenced by educational level. The Brief Cognitive Screening Battery (BCSB) is an alternative assessment tool that provides more accurate results in individuals with less education. Objective: Our aim was to compare the MMSE and BCSB as screening tests. Methods: The MMSE and BCSB were assessed in 112 participants by two evaluators blind to the other test's result. Participants were classified according to their level of education. The influence of education level was analyzed using the Kruskal-Wallis and multiple comparison tests. Results: Scores of the MMSE (p < 0.0001) and the clock-drawing test (p < 0.0001) were influenced by education level but the delayed recall test score was not (p = 0.0804). The verbal fluency test (p = 0.00035) was influenced only by higher educational levels. It took three minutes less to apply the MMSE than to apply the BCSB (p < 0.0001). Conclusions: These findings suggest that the delayed recall test and the verbal fluency test of the BCSB are better than the MMSE and clock-drawing test as tools for evaluating cognition in people with limited education.

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Cognitive deficits in chronic pain patients, in a brief screening test, are independent of comorbidities and medication use

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20160071 ◽

2016 ◽

Vol 74 (5) ◽

pp. 361-366 ◽

Cited By ~ 16

Author(s):

Karen dos Santos Ferreira ◽

Gabriela Zucatto Oliver ◽

Débora Carinhato Thomaz ◽

Caroliny Trevisan Teixeira ◽

Maria Paula Foss

Keyword(s):

Chronic Pain ◽

Verbal Fluency ◽

Screening Test ◽

Medication Use ◽

Verbal Fluency Test ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test ◽

Brief Screening ◽

Fluency Test

ABSTRACT Objective To describe and analyze cognitive aspects in patients with chronic pain and a control group without pain. Method A case-control study was conducted on 45 patients with chronic pain and on 45 control subjects. Data including pain diagnosis, comorbidities and medication used, were evaluated. Cognitive tests, such as the Montreal Cognitive Assessment (MoCA), Verbal Fluency Test, Clock Drawing Test and Stroop Test, were applied. Results Patients with chronic pain showed a poorer performance, as shown by the scores of the MoCA test (p < 0.002), Verbal Fluency Test (p < 0.001), Clock Drawing Test (p = 0.022) and Stroop Test (p < 0.000). Chronic pain variable (p = 0.015, linear regression model) was an independent factor for results obtained with the MoCA. Conclusion Patients with chronic pain showed a poorer performance in a brief screening test for cognitive impairment not related to confounding variables, as comorbidities and pain-medication use.

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Clock Drawing Test in Elderly Individuals With Different Education Levels

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/1533317512463954 ◽

2012 ◽

Vol 27 (8) ◽

pp. 620-624 ◽

Cited By ~ 9

Author(s):

Juliana Francisca Cecato ◽

Bruna Fiorese ◽

José Maria Montiel ◽

Daniel Bartholomeu ◽

José Eduardo Martinelli

Keyword(s):

Community Dwelling ◽

Clinical Dementia Rating ◽

Good Test ◽

Cross Sectional ◽

Elderly Individuals ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test ◽

Education Levels ◽

Years Of Schooling

Objective: The aim of this study was to describe the performance in Clock Drawing Test (CDT) of the elderly individuals assessed in a geriatric clinic, with at least 1 year of schooling, comparing with other groups with higher education and with Clinical Dementia Rating (CDR) levels. The study also aims to correlate the results of CDT and other used diagnostic tests for dementia by CDR levels, providing additional validity evidence to the CDT. Methods: Cross-sectional study with 426 elderly individuals, >60 years old and at least 1 year of education. All participants searched for medical assistance at Geriatric and Gerontology Ambulatory of Jundiaí city, in Brazil. The community-dwelling outpatients previously undergone a detailed clinical examination and neuropsychological evaluation: Cambrigde Cognitive Examination (CAMCOG), Mini-Mental State Examination (MMSE), andCDT. To differentiate data from diagnostic groups based on CDR, it Kruskal-Wallis test was used. Pearson statistics were calculated to compare data from CDT and CDR. The statistical analyses were 2-tailed and were considered significant when P < .05. Results: Regarding CDT, groups with more years of schooling showed similar means in CDR = 0 and CDR = 0.5 and in CDR = 1 and CDR = 2. Shulman and Sunderland scale were high score in groups with more years of education and above of cutoff points in all CDT score. On the contrary, in Mendez scale we did not observed similar means. Otherwise, in the group with less years of schooling greater means differences in the CDT were observed. Conclusion: The CDT did not show a strong correlation with MMSE and CAMCOG, both important instruments in Brazilian population to investigate dementia. For elderly individuals with high education levels, the CDT did not seem to be a good test to detect cognitive impairment.

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Understated Cognitive Impairment Assessed with the Clock-Drawing Test in Community-Dwelling Individuals Aged ≥50 Years

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2020.03.016 ◽

2020 ◽

Vol 21 (11) ◽

pp. 1658-1664 ◽

Cited By ~ 1

Author(s):

Claire Leissing-Desprez ◽

Emilie Thomas ◽

Lauriane Segaux ◽

Amaury Broussier ◽

Nadia Oubaya ◽

...

Keyword(s):

Cognitive Impairment ◽

Community Dwelling ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test

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Selected sociodemographic and clinic alpredictors of the clock drawing test performance in Polish community dwelling seniors

Aktualności Neurologiczne ◽

10.15557/an.2020.0018 ◽

2020 ◽

Vol 21 (4) ◽

pp. 187-190

Author(s):

Paula Chibowska ◽

◽

Katarzyna Nowicka-Sauer ◽

Emilia J. Sitek ◽

◽

...

Keyword(s):

Regression Analysis ◽

Depression Scale ◽

Community Dwelling ◽

Elderly Subjects ◽

Short Version ◽

Cognitive Screening ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test ◽

Wu Method

Objectives: The clock drawing test (CDT) is a commonly used cognitive screening test. The purpose of this study was to investigate the effect of selected sociodemographic, clinical and lifestyle factors on the CDT performance in the Polish elderly population. Methods: CDT performance was assessed in 399 elderly subjects randomly selected out of all participants of a nationwide study on aging, PolSenior2, who met the inclusion criteria. CDT was scored using the Manos–Wu method. The short version of the Geriatric Depression Scale (15-item GDS) was used as a mood measuring tool. Results: Our study revealed a significant relationship between CDT performance and age. Multivariate regression analysis demonstrated also that interactions between reading newspapers and gender and between playing games and GDS score were independent predictors of an incorrect CDT. Of note, even though years of education were related to the CDT score (0–10) in the correlation analysis, education did not predict the global CDT score in the regression analysis. Conclusions: Advanced age was related to incorrect CDT performance. Engagement in some leisure activities may predict the CDT score, while global CDT performance, as assessed by the Manos–Wu method, is relatively unaffected by education.

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The Mini-Cog, Clock Drawing Test, and the Mini-Mental State Examination in a German Memory Clinic: specificity of separation dementia from depression

International Psychogeriatrics ◽

10.1017/s104161021200141x ◽

2012 ◽

Vol 25 (1) ◽

pp. 96-104 ◽

Cited By ~ 8

Author(s):

Monika Milian ◽

Anna-Maria Leiherr ◽

Guido Straten ◽

Stephan Müller ◽

Thomas Leyhe ◽

...

Keyword(s):

Mental State ◽

Healthy Subjects ◽

Mini Mental State Examination ◽

Healthy Controls ◽

Depression Severity ◽

Memory Clinic ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test ◽

State Examination

ABSTRACTBackground: The aim of this study was to assess the specificities of the Mini-Cog, the Clock Drawing Test (CDT), and the Mini-Mental State Examination (MMSE) against depression and healthy controls in a German Memory Clinic. Furthermore, we analyzed the specificities of all three screening instruments in dependence of actual depression severity.Methods: Data from 142 depressed elderly, 438 dementia patients, and 64 healthy controls were retrospectively analyzed. The CDT and an extraction of the three-item recall of the MMSE were used to constitute the Mini-Cog algorithm. Depression severity was rated by either the Beck Depression Inventory (BDI) or the Geriatric Depression Scale (GDS) depending on the age of the patients.Results: The Mini-Cog achieved a specificity of 79.6% against depressed elderly and 100.0% against healthy subjects (p < 0.001). Similarly, the specificities of the CDT (83.8%) and MMSE (92.3% at a cut-off ≤24 and 90.8% at ≤25, respectively) against healthy subjects were significantly higher than the specificities against depressed patients (each p < 0.05). Concerning the depressed patients, the MMSE demonstrated significant higher specificity than the Mini-Cog and the CDT, but also showed the lowest sensitivity for the detection of dementia. Surprisingly, the depression severity had no effect on the specificity of the Mini-Cog and the CDT, only the MMSE was susceptible for the depression severity.Conclusion: Although the MMSE showed higher specificities, the weighting between the sensitivities and specificities in all tests prove again the Mini-Cog as a short, valid, and sensitive screening tool.

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