scholarly journals Validation of the Clock Drawing Test Scoring Method in older adults with neurocognitive disorder

Salud Mental ◽  
2018 ◽  
Vol 41 (4) ◽  
pp. 179-186
Author(s):  
Sara G Aguilar-Navarro ◽  
◽  
Alberto J Mimenza-Alvarado ◽  
María A Samudio-Cruz ◽  
Francisco J Hernández-Contreras ◽  
...  
Keyword(s):  
Older Adults ◽  
Quantitative Methods ◽  
Intraclass Correlation ◽  
Cognitive Status ◽  
Neurocognitive Disorder ◽  
Scoring Method ◽  
Clock Drawing Test ◽  
Cognitive Difficulties ◽  
Clock Drawing ◽  
Drawing Test

Introduction. The Clock Drawing Test (CDT) is a widely used instrument for identifying neurocognitive disorders (NCDs) in older adults. However, there is insufficient evidence to determine the best scoring method, since current quantitative methods involve the assignment of numerical values, while qualitative ones do not allow for objectivity in the diagnosis. Parsey and Schmitter-Edgecombe (2011) proposed a scoring scheme which, in addition to providing a score of the patient’s performance, permits error analysis, thereby making it possible to identify potential underlying cognitive difficulties. Objective. The purpose of this study was to validate the CDT scoring scheme proposed by Parsey and Schmitter-Edgecombe (2011) for screening for NCDs in Mexican older adults. Method. There were 167 participants: 58 cognitively healthy subjects (CH), 52 with mild neurocognitive disorder (mild-NCD), and 57 with major neurocognitive disorder (major-NCD).The CDT scoring method was compared with the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment in Spanish (MoCA-S). Inter- and intra-observer reliability and construct validity were determined and the sensitivity and specificity of this method were calculated. Results. The  age was 75 years (SD ± 8 years) and the  educational attainment was 10.7 years (SD ± 5.2 years). Internal reliability was .750, with an intraclass correlation coefficient of .774. The cut-off point for the CDT in mild-NCD was 14 points (sensitivity: 40%, specificity: 70%) and 12 points for major-NCD (sensitivity: 90%, specificity: 95%).The most frequent errors in the CDT were: graphic, conceptual, spatial, and/or planning difficulties. Discussion and conclusion. This method makes it possibly to quickly and easily explore the cognitive status of the patient. It contains ideal psychometric properties for the detection of patients with major-NCD, in addition to offering the possibility of analyzing performance errors and underlying cognitive difficulties.

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.

scholarly journals Usefulness of clock-drawing test in Indian older adults with diabetes mellitus

2020 ◽  
Vol 62 (1) ◽  
pp. 59
Author(s):  
RakeshKumar Tripathi ◽  
Yashi Verma ◽  
Anamika Srivastava ◽  
TanuShree Shukla ◽  
Kauser Usman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Older Adults ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test

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 The use of the Clock Drawing Test in bipolar disorder with or without dementia of Alzheimer’s type

2014 ◽  
Vol 72 (12) ◽  
pp. 913-918 ◽  
Author(s):  
Ivan Aprahamian ◽  
Marcia Radanovic ◽  
Paula Villela Nunes ◽  
Rodolfo Braga Ladeira ◽  
Orestes Vicente Forlenza
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Screening Tests ◽  
Elderly Subjects ◽  
Limited Data ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test ◽  
Dementia Of Alzheimer’S Type ◽  
State Examination

There is limited data regarding the cognitive profile from screening tests of older adults with bipolar disorder (BD) with dementia. Objective To investigate the Clock Drawing Test (CDT) among older adults with BD with and without Alzheimer’s disease (AD). Method 209 older adults (79 with BD without dementia and 70 controls; 60 with AD, being 27 with BD) were included to evaluate the performance of three CDT scoring scales, beyond the Mini-Mental State Examination (MMSE) and verbal fluency (VFT). Results Patients with BD without dementia presented with lower scores in MMSE, VF and one CDT scoring scale than controls. Patients with BD and AD presented with lower scores in VF and CDT scoring scales than patients with only AD. All CDT scales presented similar sensitivity and specificity for BD and non-BD groups. Conclusion Elderly subjects with BD showed greater impairment in CDT in both groups of normal cognition and AD.

scholarly journals Can a combination of two neuropsychological tests screen for mild neurocognitive disorder better than each test alone? A cross-sectional study

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Reem Mohamed Sabry ELbedewy ◽  
Mohamed ELOKL
Keyword(s):  
Verbal Fluency ◽  
Neurocognitive Disorder ◽  
Boston Naming Test ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Neurocognitive Tests ◽  
Drawing Test ◽  
Neurocognitive Test ◽  
Animal Category ◽  
Naming Test

Abstract Background Early symptoms of dementia may not be apparent and are sometimes even concealed during short office visits initiated for other complaints. The aim of the study is to find out if the combined use of VF/CDT, VF/BNT, or CDT/BNT could improve the accuracy of detecting mild NCD in an outpatient setting, compared with either test used alone. Participants Community-dwelling older adults, attending the outpatient Geriatrics Clinic at Ain Shams University hospitals between June 1, 2017 and January 31, 2018. All participants received a comprehensive geriatric assessment (CGA) which included the mini-mental state examination test. Participants with a score of less than 24 and fulfil DSM5 criteria for mild neurocognitive disorder (NCD) are considered cognitively impaired otherwise are considered normal. Then participants were further examined by the Arabic versions of CDT, BNT, and VF animal category. Results We recruited 143 male and female participants mean age 67.17 ± 5.41, females are 56.6%, and 48.9% of all participants have mild NCD according to DSM5 criteria. AUC for individual neurocognitive tests in illiterates is 0.893 for clock drawing test, 0.907 for verbal fluency animal category, and 0.904 for Boston naming test, while AUC for neurocognitive test combinations in illiterates is 0.932 for VF + CDT, 0.917 for VF + BNT, and 0.932 for BNT + CDT. On the other hand, AUC for individual neurocognitive tests in educated participants is 0.925 for clock drawing test, 0.921 for verbal fluency animal category, and 0.907 for Boston naming test, whereas AUC for neurocognitive test combinations in educated participants is 0.958 for VF + CDT, 0.963 for VF + BNT, and 0.953 for BNT + CDT. Conclusion From the current study, we can conclude that any of the studied combinations have better diagnostic accuracy (although small) than individual test in both literate and illiterate older adults.

scholarly journals Diabetes and cognitive outcomes in a nationally representative sample: the National Health and Aging Trends Study

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 ◽  
...  
Keyword(s):  
Older Adults ◽  
Test Performance ◽  
Representative Sample ◽  
Cognitive Outcomes ◽  
Word Recall ◽  
Dementia Diagnosis ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test ◽  
Nationally Representative

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.

Frequencies and Neuropsychological Characteristics of Errors in the Clock Drawing Test

2021 ◽  
pp. 1-10
Author(s):  
Hiroyuki Umegaki ◽  
Yusuke Suzuki ◽  
Hitoshi Komiya ◽  
Kazuhisa Watanabe ◽  
Yosuke Yamada ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Status ◽  
Cognitively Normal ◽  
Clock Drawing Test ◽  
Assessment Scores ◽  
Clock Drawing ◽  
Neurocognitive Assessment ◽  
Drawing Test ◽  
Neuropsychological Characteristics ◽  
Neuropsychological Assessments

Background: Few studies have investigated associations between types of clock drawing test (CDT) errors and cognitive impairment. Objective: To explore associations of qualitative errors in the CDT with comprehensive neurocognitive assessment scores and clinical diagnosis. Methods: Outpatients at a memory clinic were enrolled. Frequencies of errors determined by Cahn’s method were explored according to cognitive status (cognitively normal [CN] (n = 279), mild cognitive impairment [MCI] (n = 321), and Alzheimer’s disease [AD]) (n = 575). Neuropsychological assessment scores were compared between participants with and without errors. Results: Stimulus-bound response (SB) was relatively rare (6.8%) in the CN group but was markedly more common in the MCI (23.4%) and AD (33.2%) groups. Conceptual deficit (CD) was found in more than 20%of CN individuals, as well as about 50%of AD patients. Planning deficit (PD) frequencies were relatively similar among the groups. SB in both of CN and MCI individuals, and CD in both of CN and MCI individuals were associated with lower scores in several neuropsychological assessments. Meanwhile, PD was not associated with lower assessment scores in any of CN, MCI, or AD individuals. Conclusion: The frequencies of SB and CD increased from CN, MCI, to AD but showed somewhat different patterns. Both SB and CD were associated with lower cognition in all three cognitive stages.

scholarly journals C-34 An Investigation into the Multicultural Properties of the Clock Drawing Test: Findings from a Russian-speaking Sample

2019 ◽  
Vol 34 (6) ◽  
pp. 1063-1063
Author(s):  
N Coolbrith ◽  
D Gold ◽  
R Cobb ◽  
I Piryatinksy
Keyword(s):  
Cognitive Impairment ◽  
Neuropsychological Testing ◽  
English Speakers ◽  
Neurocognitive Disorder ◽  
Contingency Analysis ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Russian Speakers ◽  
Drawing Test ◽  
English Speaking

Abstract Objective The Clock Drawing Test (CDT) is a screening instrument for cognitive impairment known for its quick and easy administration style. Studies have examined if different qualitative errors on the CDT discriminate cognitive impairment from normal aging. Moreover, current research has investigated qualitative errors on the CDT in various populations (i.e. Brazil, Japan, Korea). To the best of the authors’ knowledge however, there has been no previous research on qualitative errors seen on the CDT within Russian-speaking populations. To address this gap, the present study examined qualitative errors committed on the CDT by native Russian-speakers compared to English-speaking counterparts. Method Data was retrospectively collected from a sample comprised of 13 Russian-speaking immigrants and 29 English-speakers. All participants were seen for neuropsychological testing at an outpatient clinic in eastern Massachusetts and diagnosed with major neurocognitive disorder. Results Contingency analysis revealed no significant differences in qualitative errors when comparing Russian-speakers with major neurocognitive disorder to English-speakers diagnosed with the same. Conclusions Due to similar frequencies of qualitative errors between these groups, these results suggest that the CDT may have broad utility for assessing gross cognitive functioning regardless of a patient’s native language or cultural background.

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