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Clock Drawing Test – screening utility for mild cognitive impairment according to different scoring systems: results of the Leipzig Longitudinal Study of the Aged (LEILA 75+)

Published online by Cambridge University Press:  04 August 2011

Lena Ehreke ,
Tobias Luck ,
Melanie Luppa ,
Hans-Helmut König ,
Arno Villringer  and
Steffi G. Riedel-Heller
Lena Ehreke*
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
Tobias Luck
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany LIFE – Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
Melanie Luppa
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
Hans-Helmut König
Affiliation:
Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Arno Villringer
Affiliation:
Max Planck Institute for Human Cognitive and Brain Sciences and Day Clinic of Cognitive Neurology, University of Leipzig, Leipzig, Germany
Steffi G. Riedel-Heller
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
*
Correspondence should be addressed to: Lena Ehreke, Institute of Social Medicine, Occupational Health and Public Health, Philipp-Rosenthal-Straße 55, D-04103 Leipzig, Germany. Phone +49-341-9724591; Fax +49-341-9724569. Email: Lena.Ehreke@medizin.uni-leipzig.de.
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Abstract

Background: There is a strong demand for screening instruments for mild cognitive impairment (MCI), as a pre-stage of dementia. The clock drawing test (CDT) is widely used to screen for dementia, but the utility in screening for MCI remains uncertain. In particular, it is still questionable which scoring system is the best in order to screen for MCI. We therefore aimed to compare the utility of different CDT scoring systems for screening for MCI.

Methods: In a sample of 428 subjects of the Leipzig Longitudinal Study of the Aged (LEILA 75+) study, CDT scores of different scoring systems were compared between subjects with and without MCI. Comparison of receiver operating characteristic (ROC; area under the curve, sensitivity, specificity) was performed and inter-rater reliability was calculated.

Results: The CDT scores differed significantly between MCI and non-MCI subjects according to all scoring systems applied. However, ROC of the CDT scores was not adequate.

Conclusions: None of the present CDT scoring systems has sufficient utility to screen reliably for MCI. The clinical value of the CDT could be improved by using semi-quantitative scoring, having a wider score range and focusing on specific details of the clock (e.g. the hands and numbers).

Keywords

Clock Drawing Testscoring systemdementiaMCI
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 10 , December 2011 , pp. 1592 - 1601
Copyright
Copyright © International Psychogeriatric Association 2011

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