Clock drawing test in very mild Alzheimer's Disease
Clock drawing test in very mild Alzheimer's Disease
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DOI：
10.1111/j.1532-5415.1998.tb04543.x
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发表时间：
1998-10-01
影响因子：
6.3
通讯作者：
Geldmacher, DS
中科院分区：
文献类型：
--
作者：
Esteban-Santillan, C;Praditsuwan, R;Geldmacher, DS
目的：本研究的主要目的是确定画钟试验预测极轻度阿尔茨海默病（AD）存在的有效性。第二个目标是确定钟表绘制的元素，这些元素在区分认知完整的老年人和轻度阿尔茨海默病患者中最有用。设计：基于队列的回顾性数据比较。单位：学术研究中心。参与者：来自41例轻度AD门诊病例的时钟图，其简易精神状态检查评分为24或更高，年龄和教育程度为39测量：两个评估者使用时钟绘图解释量表和Rouleau等人报告的评分系统对时钟绘图进行盲法和独立评分。使用这两个系统中的每一个的总分和分量子分数的截止分数计算阳性和阴性测试的预测值。两个或两个以上的错误，在时钟绘制解释量表上的时钟指针的描述AD的阳性预测值为100%，阴性预测值为51%。Rouleau等的4点指针位置评分≤ 2分，AD的阳性预测值为94%，阴性预测值为62%。结论：在绘制时钟指针时出现2次或2次以上错误的个体，其痴呆可能性值得进一步研究。正常的手放置在时钟绘图测试并不排除AD。然而，当考虑社区居住的老年人痴呆症的患病率时，这些结果表明，正常的时钟指针位置表明痴呆症是不可能的。
OBJECTIVES: The primary objective of this study was to determine the efficacy of the clock drawing test to predict the presence of very mild Alzheimer's disease (AD). A secondary objective was to identify elements of clock drawing that were most useful in differentiating cognitively intact older adults from those with mild Alzheimer's disease.DESIGN: Cohort based comparison of retrospective data.SETTING: Academic research center.PARTICIPANTS: Clock drawings from 41 outpatient cases of mild AD with Mini-Mental State Exam scores of 24 or higher and 39 age- and education-matched older adults were scored.MEASUREMENTS: Clock drawings were blindly and independently scored by two raters using the Clock Drawing Interpretation Scale and the scoring system reported by Rouleau et al. Predictive values for positive and negative tests were calculated using cut-off scores for total score and component subscores from each of these two systems.RESULTS: Two or more errors in the depiction of the clock hands on the Clock Drawing Interpretation Scale had a positive predictive value for AD of 100% and a negative predictive value of 51%. A score of 2 or less on the 4-point hand-placement component of the Rouleau et al. scoring system provided a positive predictive value for AD of 94% and was associated with a negative predictive value of 62%.CONCLUSION: An individual who commits two errors or more in drawing the clock hands deserves further investigation for a possible dementia. Normal hand placement on the clock drawing test does not exclude AD. However, when prevalence rates of dementia in community-dwelling older adults are considered, these results argue that normal clock hand placement indicates that dementia is unlikely.