scholarly journals Opportunistic cognitive screening in Sweden: What the tests mean and do for patients and healthcare professionals

Dementia ◽  
2021 ◽  
pp. 147130122110353
Author(s):  
Kristin Zeiler ◽  
Göran Karlsson ◽  
Martin Gunnarson
Keyword(s):  
Cognitive Impairment ◽  
Science And Technology Studies ◽  
Healthcare Professionals ◽  
Opportunistic Screening ◽  
Cognitive Screening ◽  
Clock Drawing Test ◽  
Screening Practice ◽  
Drawing Test ◽  
State Examination

Since 2017, opportunistic screening for cognitive impairment takes place at the geriatric ward of a local hospital in Sweden. Persons above the age of 65 who are admitted to the ward, who have not been tested for cognitive impairment during the last six months nor have a previously known cognitive impairment, are offered the Mini-Mental State Examination and the Clock-Drawing Test. This article analyses what the opportunistic screening practice means for patients and healthcare professionals. It combines a phenomenologically-oriented focus on subjectivity and sense-making with a focus that is inspired by science and technology studies on what the tests become within the specific context in which they are used, which allows a dual focus on subjectivity and performativity. The article shows how the tests become several different, not infrequently seemingly contradictory, things: an offer, an important tool for knowledge-production, something unproblematic yet also emotionally troubling, something one can fail and an indicator that one belongs to a risk group and needs to be tested. Further, the article shows how the practice is shaped by the sociocultural context. It examines the role of the affective responses to the test for subjectivity – particularly patient subjectivity – and offers a set of recommendations, if this practice were to expand to other hospitals.

scholarly journals The Clock Drawing Test: Performance differences between the free-drawn and incomplete-copy versions in patients with MCI and dementia

2016 ◽  
Vol 10 (3) ◽  
pp. 227-231 ◽  
Author(s):  
Bárbara Costa Beber ◽  
Renata Kochhann ◽  
Bruna Matias ◽  
Márcia Lorena Fagundes Chaves
Keyword(s):  
Cognitive Impairment ◽  
Test Performance ◽  
Diagnostic Value ◽  
Control Group ◽  
Cognitive Screening ◽  
Scoring Method ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Healthy Elderly ◽  
Drawing Test

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.

Is the Clock Drawing Test a screening tool for the diagnosis of mild cognitive impairment? A systematic review

2009 ◽  
Vol 22 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Lena Ehreke ◽  
Melanie Luppa ◽  
Hans-Helmut König ◽  
Steffi G. Riedel-Heller
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Literature Search ◽  
Screening Tool ◽  
Cognitive Screening ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test ◽  
Diagnosis Of Dementia ◽  
Mean Differences

ABSTRACTBackground:The clock drawing test (CDT) is a common and widely used cognitive screening instrument for the diagnosis of dementia. However, it has remained unclear whether it is a suitable method to identify mild cognitive impairment (MCI). The aim of this paper is to review systematically the studies concerning the utility of the CDT in diagnosing MCI.Method:A systematic literature search was conducted. All studies dealing with utility of CDT in diagnosing MCI regardless of the applied CDT scoring system and MCI concept were selected.Results:Nine relevant studies were identified. The majority of the studies compared average CDT scores of cognitively healthy and mildly impaired subjects, and four of them identified significant mean differences. If reported, sensitivity and specificity have been mostly unsatisfactory.Conclusion:CDT should not be used for MCI-screening.

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

2019 ◽  
Vol 77 (5) ◽  
pp. 330-334 ◽  
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.

scholarly journals Assessment for apraxia in Mild Cognitive Impairment and Alzheimer's disease

2015 ◽  
Vol 9 (1) ◽  
pp. 71-75 ◽  
Author(s):  
Mirela Ward ◽  
Juliana F. Cecato ◽  
Ivan Aprahamian ◽  
José Eduardo Martinelli
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Mini Mental State Examination ◽  
Average Score ◽  
Clock Drawing Test ◽  
Healthy Elderly ◽  
Drawing Test ◽  
State Examination

OBJECTIVE: To evaluate apraxia in healthy elderly and in patients diagnosed with Alzheimer's disease (AD) and Mild cognitive impairment (MCI). METHODS: We evaluated 136 subjects with an average age of 75.74 years (minimum 60 years old, maximum 92 years old) and average schooling of 9 years (minimum of 7 and a maximum of 12 years), using the Mini-Mental State examination (MMSE), Cambridge Cognitive Examination (CAMCOG) and the Clock Drawing Test. For the analysis of the presence of apraxia, eight subitems from the CAMCOG were selected: the drawings of the pentagon, spiral, house, clock; and the tasks of putting a piece of paper in an envelope; the correct one hand waiving "Goodbye" movements; paper cutting using scissors; and brushing teeth. RESULTS: Elder controls had an average score of 11.51, compared to MCI (11.13), and AD patients, whose average apraxia test scores were the lowest (10.23). Apraxia scores proved able to differentiate the three groups studied (p=0.001). In addition, a negative correlation was observed between apraxia and MMSE scores. CONCLUSION: We conclude that testing for the presence of apraxia is important in the evaluation of patients with cognitive impairments and may help to differentiate elderly controls, MCI and AD.

scholarly journals Mapping the clockworks: what does the Clock Drawing Test assess in normal and pathological aging?

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
Keyword(s):  
Executive Functions ◽  
Test Performance ◽  
Semantic Knowledge ◽  
Cognitive Status ◽  
Cognitive Screening ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Cognitive Components ◽  
Drawing Test

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.

scholarly journals UNVEILING THE HUNDRED CLOAKS OF COGNITIVE IMPAIRMENT – THE ROLE OF PATTERNS IN THE CLOCK DRAWING TEST

2019 ◽  
Author(s):  
Diana Margarida Rocha Pereira ◽  
Teresa Prior Filipe ◽  
Ana Margarida Mota ◽  
Nuno Rodrigues ◽  
Joana Peta ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test

Clock Drawing Test: A Simple Scoring System for the Accurate Screening of Cognitive Impairment in Patients with Mild Cognitive Impairment and Dementia

2018 ◽  
Vol 45 (5-6) ◽  
pp. 326-334 ◽  
Author(s):  
Martin Rakusa ◽  
Joze Jensterle ◽  
Janez Mlakar
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Scoring System ◽  
Mini Mental State Examination ◽  
Screening Method ◽  
Mixed Dementia ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test ◽  
State Examination

Background/Aim: The Clock Drawing Test (CDT) is a valid alternative screening tool to the Mini-Mental State Examination (MMSE) and, crucially, it may be completed faster. The aim of our study was to standardize and simplify the CDT scoring system for screening in three common conditions: mild cognitive impairment (MCI), Alzheimer’s disease (AD) and mixed dementia (MD). Methods: We included 188 subjects (43 healthy volunteers, 49 patients with MCI, 54 patients with AD, and 42 patients with MD), who performed the MMSE and CDT. The CDT was evaluated using a modified 4-point scoring system. Results: The healthy subjects had the highest median values for the MMSE and CDT, followed by patients with MCI, AD and MD. The optimal cut-off for all patients and each patient group separately was 3 out of 4 points. Sensitivity was 89% for AD, 93% for MD and 83% for all patients, while specificity was 91%. The MMSE produced similar results. In comparison to the MMSE, sensitivity for MCI was significantly higher using the CDT (20 vs. 69%, respectively). Conclusion: A simple, 4-point scoring system may be used as a screening method for fast and accurate detection of cognitive impairment in patients with MCI, AD and MD.

scholarly journals Performance of the Pentagon Drawing test for the screening of older adults with Alzheimer's dementia

2018 ◽  
Vol 12 (1) ◽  
pp. 54-60 ◽  
Author(s):  
José Eduardo Martinelli ◽  
Juliana Francisca Cecato ◽  
Marcos Oliveira Martinelli ◽  
Brian Alvarez Ribeiro de Melo ◽  
Ivan Aprahamian
Keyword(s):  
Older Adults ◽  
Cross Sectional Study ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
Clock Drawing Test ◽  
Drawing Test ◽  
Neuropsychological Evaluations ◽  
Cognitive Screen ◽  
State Examination ◽  
Test Objective

ABSTRACT The Pentagon Drawing Test (PDT) is a common cognitive screening test. Objective: The aim of this study was to evaluate performance properties of a specific PDT scoring scale in older adults with Alzheimer's disease (AD) and healthy controls. Methods: A cross-sectional study of 390 elderly patients, aged 60 years or older with at least two years of education was conducted. All participants completed clinical and neuropsychological evaluations, including the Cambridge Cognitive Examination, the Mini-Mental State Examination (MMSE), and the Clock Drawing Test. All PDT were blindly scored with the scale of Bourke et al. Results: PDT analyses of the binary score on the MMSE (0 or 1 point) did not discriminate AD from controls (p = 0.839). However, when PDT was analyzed using the Bourke et al. scale, the two groups could be distinguished (p <0.001). PDT was not affected by education, showed sensitivity of 85.5% and specificity of 66.9%, discriminated different clinical stages of dementia, and correlated with the other cognitive tests (p <0.001). A 1-point difference on the Bourke et al. scale was associated with an odds ratio of 3.46 for AD. Conclusion: PDT can be used as a cognitive screen for suspected cases of dementia, especially AD, irrespective of educational level.

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