Validity of the Clock-Drawing Test as a screening tool for cognitive impairment in the elderly
Validity of the Clock-Drawing Test as a screening tool for cognitive impairment in the elderly
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DOI：
10.1093/aje/kwh288
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发表时间：
2004-10-15
影响因子：
5
通讯作者：
Fletcher, AE
中科院分区：
文献类型：
--
作者：
Nishiwaki, Y;Breeze, E;Fletcher, AE
作者研究了画钟测试 (CDT) 与简易精神状态检查 (MMSE) 的有效性，以及在 75 岁或以上人群的大型普通人群样本中 CDT 与死亡率之间的关联。数据来自 MRC 社区老年人评估和管理试验。 1995 年至 1999 年期间在英国进行了基线评估。分析中共有 13,557 名同时具有 CDT 和 MMSE 评分的受试者。中位随访时间为 4.7 年。 CDT 检测中重度认知障碍（MMSE 评分小于或等于 17）的敏感性和特异性在护士给药中分别为 77% 和 87%，在邮寄给药中分别为 40% 和 91%。女性的敏感性较高，并且随着年龄的增长而增加。在 Cox 比例风险回归中，较差的 CDT 评分与全因死亡率以及脑血管和呼吸系统疾病死亡率的风险增加相关，即使在调整了潜在的混杂因素后也是如此。作者得出的结论是，CDT 作为针对老年社区人群中度/重度认知障碍的简短面对面筛查工具可能具有价值，但在检测轻度认知障碍方面相对较差。
The authors studied the validity of the Clock-Drawing Test (CDT) in comparison with the Mini-Mental State Examination (MMSE) and the association between the CDT and mortality in a large general population sample of persons aged 75 years or more. Data were obtained from the MRC Trial of the Assessment and Management of Older People in the Community. Baseline assessments were conducted between 1995 and 1999 in the United Kingdom. A total of 13,557 subjects with both CDT and MMSE scores were included in the analysis. The median follow-up period was 4.7 years. The sensitivity and specificity of the CDT for detecting moderate-to-severe cognitive impairment (MMSE score less than or equal to 17) were 77% and 87%, respectively, for nurse administration and 40% and 91%, respectively, for postal administration. Sensitivity was higher among females and increased with age. In Cox proportional hazards regression, a worse CDT score was associated with increased risk of all-cause mortality and mortality from cerebrovascular and respiratory diseases, even after adjustment for potential confounders. The authors conclude that the CDT may have value as a brief face-to-face screening tool for moderate/severe cognitive impairment in an older community population but is relatively poor at detecting milder cognitive impairment.