Effects of education, literacy, and dementia on the Clock Drawing Test performance

2010 ◽  
Vol 16 (6) ◽  
pp. 1138-1146 ◽  
Author(s):  
HOYOUNG KIM ◽  
JEANYUNG CHEY

AbstractThe Clock Drawing Test (CDT) has been recognized as an effective tool for dementia detection. This study investigated the clock drawing performance of 240 non-demented elderly Korean people with a wide-range of educational levels and 28 patients with mild dementia of the Alzheimer’s type (DAT). We examined the effects of demographic factors, including education, and established norms for the elderly population. We found that the educational attainment and literacy status of older people influenced performance on the CDT significantly (p < .001). Furthermore, qualitative error analysis revealed that normal participants with low educational background committed errors similar to errors of the DAT patients. The DAT patients performed significantly worse than the non-demented participants in the CDT Total score (p < .001). However, the CDT has better criterion validity in participants with more than 6 years of education. In conclusion, the CDT performance in older people who are either illiterate or with 6 or less years of education should be interpreted with caution. Conceptual errors in the CDT can be the result of not only dementia but also lack of education. (JINS, 2010, 16, 1138–1146.)

2016 ◽  
Vol 10 (3) ◽  
pp. 227-231 ◽  
Author(s):  
Bárbara Costa Beber ◽  
Renata Kochhann ◽  
Bruna Matias ◽  
Márcia Lorena Fagundes Chaves

ABSTRACT Background: The Clock Drawing Test (CDT) is a brief cognitive screening tool for dementia. Several different presentation formats and scoring methods for the CDT are available in the literature. Objective: In this study we aimed to compare performance on the free-drawn and "incomplete-copy" versions of the CDT using the same short scoring method in Mild Cognitive Impairment (MCI) and dementia patients, and healthy elderly participants. Methods: 90 participants (controlled for age, sex and education) subdivided into control group (n=20), MCI group (n=30) and dementia group (n=40) (Alzheimer's disease - AD=20; Vascular Dementia - VD=20) were recruited for this study. The participants performed the two CDT versions at different times and a blinded neuropsychologist scored the CDTs using the same scoring system. Results: The scores on the free-drawn version were significantly lower than the incomplete-copy version for all groups. The dementia group had significantly lower scores on the incomplete-copy version of the CDT than the control group. MCI patients did not differ significantly from the dementia or control groups. Performance on the free-drawn copy differed significantly among all groups. Conclusion: The free-drawn CDT version is more cognitively demanding and sensitive for detecting mild/early cognitive impairment. Further evaluation of the diagnostic value (accuracy) of the free-drawn CDT in Brazilian MCI patients is needed.


2009 ◽  
Vol 3 (2) ◽  
pp. 74-80 ◽  
Author(s):  
Ivan Aprahamian ◽  
José Eduardo Martinelli ◽  
Anita Liberalesso Neri ◽  
Mônica Sanches Yassuda

Abstract The Clock Drawing Test (CDT) is a simple neuropsychometric instrument that can be easily applied to assess several cognitive functions. Over the past 20 years, the CDT has aroused considerable interest in its role for the early screening of cognitive impairment, especially in dementia. Although the CDT is considered an accurate test for dementia screening, recent studies including comparisons with structured batteries such as the CAMCOG have shown mixed results. Objectives: To investigate the importance of the CDT compared to other commonly used tests, in the diagnosis of dementia in the elderly; (2) to evaluate the reliability and correlation between available CDT scoring scales from recent studies. Methods: A systematic search in the literature was conducted in September 2008 for studies comparing CDT scoring systems and comparing the CDT with neuropsychiatric batteries. Results: Twelve studies were selected for analyses. Seven of these studies compared CDT scoring scales while five compared the CDT against the CAMCOG and the MMSE. Eight studies found good correlation and reliability between the scales and the other tests. Conclusion: Despite the mixed results in these studies, the CDT appears to be a good screening test for dementia.


2013 ◽  
Vol 71 (10) ◽  
pp. 763-768 ◽  
Author(s):  
Jonas Jardim de Paula ◽  
Debora Marques de Miranda ◽  
Edgar Nunes de Moraes ◽  
Leandro Fernandes Malloy-Diniz

The Clock Drawing Test (CDT) is a cognitive screening tool used in clinical and research settings. Despite its role on the assessment of global cognitive functioning, the specific cognitive components required for test performance are still unclear. We aim to assess the role of executive functioning, global cognitive status, visuospatial abilities, and semantic knowledge on Shulman’s CDT performance. Fifty-three mild cognitive impairment, 60 Alzheimer’s dementia, and 57 normal elderly controls performed the CDT, the Frontal Assessment Battery, the Mini-Mental State Examination, the Stick Design Test, and a naming test (TN-LIN). An ordinal regression assessed specific neuropsychological influences on CDT performance. All the cognitive variables were related to the CDT, accounting for 53% of variance. The strongest association was between the CDT and executive functions, followed by global cognitive status, visuospatial processing, and semantic knowledge. Our result confirms the multidimensional nature of the test and the major role of executive functions on performance.


2008 ◽  
Vol 60 (2) ◽  
pp. 73-78 ◽  
Author(s):  
Armin von Gunten ◽  
Marzanna Ostos-Wiechetek ◽  
Juliette Brull ◽  
Ines Vaudaux-Pisquem ◽  
Sylvie Cattin ◽  
...  

2014 ◽  
Vol 26 (10) ◽  
pp. 1729-1735 ◽  
Author(s):  
Alexandra M. V. Wennberg ◽  
Rebecca F. Gottesman ◽  
Christopher N. Kaufmann ◽  
Marilyn S. Albert ◽  
Lenis P. Chen-Edinboro ◽  
...  

ABSTRACTBackground:The prevalence of both type II diabetes mellitus (DM) and cognitive impairment is high and increasing in older adults. We examined the extent to which DM diagnosis was associated with poorer cognitive performance and dementia diagnosis in a population-based cohort of US older adults.Methods:We studied 7,606 participants in the National Health and Aging Trends Study, a nationally representative cohort of Medicare beneficiaries aged 65 years and older. DM and dementia diagnosis were based on self-report from participants or proxy respondents, and participants completed a word-list memory test, the Clock Drawing Test, and gave a subjective assessment of their own memory.Results:In unadjusted analyses, self-reported DM diagnosis was associated with poorer immediate and delayed word recall, worse performance on the Clock Drawing Test, and poorer self-rated memory. After adjusting for demographic characteristics, body mass index, depression and anxiety symptoms, and medical conditions, DM was associated with poorer immediate and delayed word recall and poorer self-rated memory, but not with the Clock Drawing Test performance or self-reported dementia diagnosis. After excluding participants with a history of stroke, DM diagnosis was associated with poorer immediate and delayed word recall and the Clock Drawing Test performance, and poorer self-rated memory, but not with self-reported dementia diagnosis.Conclusions:In this recent representative sample of older Medicare enrollees, self-reported DM was associated with poorer cognitive test performance. Findings provide further support for DM as a potential risk factor for poor cognitive outcomes. Studies are needed that investigate whether DM treatment prevents cognitive decline.


e-CliniC ◽  
2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Reza B. Susanto ◽  
Rizal Tumewah ◽  
Arthur H. P. Mawuntu

Abstract: Indonesia has the highest growth of elderly population. Health problem that often occurs in the elderly is impaired cognitive function which can be examined by using various examinations. Rapid examinations with practical high values are Mini Mental State Examination (MMSE), Clock Drawing Test (CDT), as well as Trail Making Test A and B (TMT A and B). These are done by giving a series of commands to a person and then his/her accuracy will be assessed. This was a cross-sectional study conducted from December 2014 to January 2015 at the Agape elderly nursing home Tondano. The results showed that there were 12 respondents that met the inclusion criteria consisted of eight females and four males. The results of the four tests showed that MMSE had 67% of respondents with normal cognitive function, CDT had 75% with normal executive function, TMT A had 100% with experienced executive interference, and TMT B had 92% with experienced executive interference. Conclusion: Most respondents showed MMSE with normal cognitive function and CDT with, normal executive function, however, all respondents showed TMT A with experienced executive interference, and nearly all respondents showed TMT B with experienced executive interference. Cognitive dysfunction were more frequent among the elderly of ≥75 years, female, primary school education, and unemployment.Keywords: elderly, cognitive function, executive functionAbstrak: Indonesia merupakan negara tertinggi dalam pertumbuhan penduduk lanjut usia. Peningkatan jumlah penduduk lanjut usia tersebut menimbulkan masalah kesehatan, masalah kesehatan yang sering terjadi pada usia lanjut antara lain gangguan fungsi kognitif. Gangguan fungsi kognitif ini dapat di periksa dengan berbagai pemeriksaan. Pemeriksaan yang cepat dan praktis namun nilainya tinggi adalah pemeriksaan Mini Mental State Examination (MMSE), Clock Drawing Test (CDT), Trail Making Test A dan B (TMT A dan B). Pemeriksaan ini dilakukan dengan memberi serangkaian perintah pada seseorang dan ketepatannya dinilai. Penelitian ini menggunakan desain potong lintang, dilakukan pada bulan Desember 2014 hingga Januari 2015 bertempat di Panti Werdha Agape Tondano. Hasil penelitian mendapatkan 12 responden yang memenuhi kriteria penelitian, terdiri dari 8 perempuan dan 4 laki-laki. Hasil pemeriksaan MMSE menunjukkan 67% responden dengan fungsi kognitif normal, CDT menunjukkan 75% dengan fungsi eksekutif normal, TMT A menunjukkan 100% dengan gangguan eksekutif, dan TMT B menunjukkan 92% mengalami gangguan eksekutif. Simpulan: Sebagian besar responden menunjukkan hasil pemeriksaan MMSE dengan fungsi kognitifnya normal, CDT dengan fungsi eksekutif normal, sedangkan untuk TMT A seluruh responden mengalami gangguan eksekutif, dan TMT B hampir seluruh responden mengalami gangguan eksekutif. Secara keseluruhan, gangguan fungsi kognitif lebih banyak pada lansia perempuan usia ≥ 75 tahun, pendidikan SD, dan tidak bekerja.Kata kunci: lansia, fungsi kognitif, fungsi eksekutif


2021 ◽  
Vol 11 (10) ◽  
pp. 204-214
Author(s):  
Volodymyr Sekretnyi ◽  
Oleh Nekhanevych

  Introduction Significant part of sports related concussions (SRC) are below the level of clinical diagnosis of SRC or are unnoticed. The most severe cumulative consequence of SRC is chronic traumatic encephalopathy (CTE). The study of a wide range of clinical manifestations of CTE plays an important role. Purpose To establish long-term cognitive consequences of TBI in ice hockey players. Material and methods Retrospectively, we tested retired 20 ice hockey players. All athletes completed a questionnaire with their team doctor, which included: passport part, sports history, history of SRC, a mini mental scale evaluation (MMSE) and «the clock drawing test». Results The results of the analysis showed a statistically significant decrease in the value of MMSE with an increase in SRC more than 1 during a sports career. Thus, in the group with 1 SRC the value of MMSE was 28.7 (1.38) points, while in the group with 2 or more SMS it was equal to 26.7 (1.15) points (p <0.05). MMSE goalkeepers scored 26.6 (0.6) points, strikers – 27.8 (0.4) points, defenders – 28.2 (0.7) points (p<0.05). The fact of hospitalization indicates clinically significant severity of a history of SRC. Having retrospectively collected data on hospitalization of hockey players after SRC, there was also a decrease in the value of MMSE in those with a history of hospitalization. Thus, in the group of people with hospitalization MMSE was 27.1 (1.39) points, without hospitalization – 27.9 (1.7). No statistically relationship between age and severity of cognitive impairment was found. Significant statistic connection (n = 20, correlation coefficient rs = – 0.40; p<0.05) has been found between the number of SRC and the indicator and MMSE test and between number of SRC and «the clock drawing test» (n = 20, correlation coefficient rs = – 0.10; p <0.05). Conclusions Our study has outlined connection between cognitive impairment in ice-hockey players and SRC.


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