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Comparison of the different approaches of drawing test for the detection of dementia and mild cognitive impairment: A systematic review and meta‐analysis
Author(s) -
Chan Joyce YC,
Chan Tak Kit,
Tsoi Kelvin KF
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.040852
Subject(s) - dementia , psycinfo , meta analysis , bivariate analysis , test (biology) , medline , cognitive impairment , cognition , psychology , cognitive test , clinical psychology , medicine , psychiatry , computer science , machine learning , disease , paleontology , political science , law , biology
Background Drawing tests are commonly used to detect dementia and mild cognitive impairment (MCI). It is because drawing tests aim to assess visuo‐spatial ability and executive functions, and the deterioration of visuospatial abilities and executive functions is one of the common cognitive symptoms in patients with dementia and MCI. However, there are various types and administrative approaches of the drawing tests, and their diagnostic performance may vary. Thus, this study aims to evaluate the diagnostic performance of different approaches of the drawing tests for the detection dementia and MCI. Methods This study is a systematic review and meta‐analysis. Literature searches on each of the drawing tests were performed in OVID databases including MEDLINE, EMBASE, and PsycINFO from the earliest available dates of individual databases to September 1, 2019. Studies that were used to assess the diagnostic performance of the drawing tests to detect dementia or MCI were included. Each test’s performance was compared with the standard diagnostic criteria. Bivariate random‐effects models were used to summarize the test performance as a point estimate for sensitivity and specificity. Results A total of 64 studies with 15,567 participants were included to compare different approaches of the drawing tests. Most studies used clock drawing with command approach test (87%), 6 studies used clock drawing with copy approach (10%). In the detection of dementia and MCI, the sensitivity and specificity of command approach were 0.75 and 0.70, respectively, and copy approach were 0.52 and 0.85, respectively. The digital clock drawing tests showed good diagnostic accuracy, the sensitivity was 0.87 and the specificity was 0.89. The digital and traditional pentagon drawing tests were with good sensitivity but fair specificity (Table 1). Conclusions This study showed that the digital clock drawing tests have better diagnostic performance than the traditional clock drawing tests. In the comparison between different approaches of traditional clock drawing tests, the command approach have better diagnostic performance than the copy approach. Digital drawing tests have higher sensitivity than traditional approaches, so the development of digital drawing tests are important and useful in the aging population.