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P3‐101: Clock drawing test: Modified and integrated approach (CDT‐MIA) in patients with Alzheimer's disease and vascular dementia
Author(s) -
Witoonpanich Pirada,
Rattanasiri Sasivimol,
Sukying Chakrit
Publication year - 2010
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 - 10.1016/j.jalz.2010.05.1598
Subject(s) - dementia , medicine , vascular dementia , cognitive impairment , disease , alzheimer's disease
Background: Clock drawing test (CDT) has been used as a screening test for cognitive impairment. It is a reliable and simple test and acceptable for the patients. The aim of this study was to evaluate dementia patients by using CDT comparing to normal elderly and to see if this test can differentiate Alzheimer’s disease (AD) from vascular dementia (VD) patients. Methods: Clock drawing test-modified and integrated approach (CDT-MIA) was used. The subjects were patients with probable AD, probable VD and mixed AD and VD and age-, sexand education-matched controls. The MMSE score and CDT-MIA total score as well as 4 subscores (contour, numbers, hands and center) were compared between each disease and control and between AD and VD patients. Sensitivity and specificity of the CDT-MIA total score in screening for dementia were estimated. Results: The subjects consisted of 27 probable AD, 18 probable VD, 14 mixed AD and VD patients and 48 controls. For the screening of dementia by the CDT-MIA, the total and numbers scores had area under ROC curve more than 0.70. The best cutoff point of total score was 20 with the sensitivity of 71.19% and the specificity of 66.67%. None of the mean CDT-MIA total and subscores was significantly different between the AD and VD groups. The mean total, numbers and hands scores of AD patients were significantly lower than those of control subjects whereas only the mean numbers score was significantly lower in VD patients comparing with control. Conclusions: The CDTMIA is a simple and reliable test in the screening of dementia patients with the total and numbers scores being the most useful parameters. In an attempt to differentiate AD from VD by this test, all the total and subscores were not significantly different. However, when each disease was compared to control, the test errors in AD were shown in total, numbers and hands scores while numbers score was the only defect in VD. This finding may imply that the pathological process in AD is more extensive and widespread than that in VD.