The Four-Point Scoring System for the Clock Drawing Test Does Not Differentiate between Alzheimer's Disease and Vascular Dementia

The purpose of this study was to explore the sensitivity and specificity of the Clock Drawing Test by using a widely employed four-point scoring system to discriminate between patients with Alzheimer's disease or vascular dementia. Receiver operating characteristic analysis indicated that the Clock Drawing Test was able to distinguish between normal elders and those with a dementia diagnosis. The cutoff score for differentiating patients with Alzheimer's disease from normal participants was = 3. The cutoff score for differentiating those with vascular disease from normal participants was = 3. Overall, the four-point scoring system demonstrated good sensitivity and specificity for identifying cognitive dysfunction associated with dementia; however, the current findings do not support the utility of the four-point scoring system in discriminating Alzheimer's disease and vascular dementia.

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Classifying Non-Dementia and Alzheimer’s Disease/Vascular Dementia Patients Using Kinematic, Time-Based, and Visuospatial Parameters: The Digital Clock Drawing Test

Journal of Alzheimer s Disease ◽

10.3233/jad-201129 ◽

2021 ◽

Vol 82 (1) ◽

pp. 47-57 ◽

Cited By ~ 1

Author(s):

Anis Davoudi ◽

Catherine Dion ◽

Shawna Amini ◽

Patrick J. Tighe ◽

Catherine C. Price ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Vascular Dementia ◽

Area Under The Curve ◽

Clock Drawing Test ◽

Digital Clock ◽

Clock Drawing ◽

Drawing Test ◽

Dementia Patients ◽

Optimal Area

Background: Advantages of digital clock drawing metrics for dementia subtype classification needs examination. Objective: To assess how well kinematic, time-based, and visuospatial features extracted from the digital Clock Drawing Test (dCDT) can classify a combined group of Alzheimer’s disease/Vascular Dementia patients versus healthy controls (HC), and classify dementia patients with Alzheimer’s disease (AD) versus vascular dementia (VaD). Methods: Healthy, community-dwelling control participants (n = 175), patients diagnosed clinically with Alzheimer’s disease (n = 29), and vascular dementia (n = 27) completed the dCDT to command and copy clock drawing conditions. Thirty-seven dCDT command and 37 copy dCDT features were extracted and used with Random Forest classification models. Results: When HC participants were compared to participants with dementia, optimal area under the curve was achieved using models that combined both command and copy dCDT features (AUC = 91.52%). Similarly, when AD versus VaD participants were compared, optimal area under the curve was, achieved with models that combined both command and copy features (AUC = 76.94%). Subsequent follow-up analyses of a corpus of 10 variables of interest determined using a Gini Index found that groups could be dissociated based on kinematic, time-based, and visuospatial features. Conclusion: The dCDT is able to operationally define graphomotor output that cannot be measured using traditional paper and pencil test administration in older health controls and participants with dementia. These data suggest that kinematic, time-based, and visuospatial behavior obtained using the dCDT may provide additional neurocognitive biomarkers that may be able to identify and tract dementia syndromes.

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P3-101: Clock drawing test: Modified and integrated approach (CDT-MIA) in patients with Alzheimer's disease and vascular dementia

Alzheimer s & Dementia ◽

10.1016/j.jalz.2010.05.1598 ◽

2010 ◽

Vol 6 ◽

pp. S480-S480 ◽

Cited By ~ 1

Author(s):

Pirada Witoonpanich ◽

Sasivimol Rattanasiri ◽

Chakrit Sukying

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Vascular Dementia ◽

Integrated Approach ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test

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P3-189: The utility of the clock drawing test: Making a differential diagnosis between Alzheimer's disease and vascular dementia

Alzheimer s & Dementia ◽

10.1016/j.jalz.2008.05.1755 ◽

2008 ◽

Vol 4 ◽

pp. T575-T576

Author(s):

April Wiechmann ◽

James Hall

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Differential Diagnosis ◽

Vascular Dementia ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test

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The accuracy of the Clock Drawing Test compared to that of standard screening tests for Alzheimer's disease: results from a study of Brazilian elderly with heterogeneous educational backgrounds

International Psychogeriatrics ◽

10.1017/s1041610209991141 ◽

2009 ◽

Vol 22 (1) ◽

pp. 64-71 ◽

Cited By ~ 54

Author(s):

Ivan Aprahamian ◽

José Eduardo Martinelli ◽

Anita Liberalesso Neri ◽

Mônica Sanches Yassuda

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Sensitivity And Specificity ◽

High Sensitivity ◽

The Elderly ◽

Screening Tests ◽

Cross Sectional ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test

ABSTRACTBackground: Although the Clock Drawing Test (CDT) is the second most used test in the world for the screening of dementia, there is still debate over its sensitivity, specificity, application and interpretation in dementia diagnosis. This study has three main aims: to evaluate the sensitivity and specificity of the CDT in a sample composed of older adults with Alzheimer's disease (AD) and normal controls; to compare CDT accuracy to the that of the Mini-mental State Examination (MMSE) and the Cambridge Cognitive Examination (CAMCOG); and to test whether the association of the MMSE with the CDT leads to higher or comparable accuracy as that reported for the CAMCOG.Methods: Cross-sectional assessment was carried out for 121 AD and 99 elderly controls with heterogeneous educational levels from a geriatric outpatient clinic who completed the Cambridge Examination for Mental Disorder of the Elderly (CAMDEX). The CDT was evaluated according to the Shulman, Mendez and Sunderland scales.Results: The CDT showed high sensitivity and specificity. There were significant correlations between the CDT and the MMSE (0.700–0.730; p < 0.001) and between the CDT and the CAMCOG (0.753–0.779; p < 0.001). The combination of the CDT with the MMSE improved sensitivity and specificity (SE = 89.2–90%; SP = 71.7–79.8%). Subgroup analysis indicated that for elderly people with lower education, sensitivity and specificity were both adequate and high.Conclusions: The CDT is a robust screening test when compared with the MMSE or the CAMCOG, independent of the scale used for its interpretation. The combination with the MMSE improves its performance significantly, becoming equivalent to the CAMCOG.

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