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The clock drawing test as a screening tool in mild cognitive impairment and very mild dementia: a new brief method of scoring and normative data in the elderly

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Abstract

many studies sustained that the clock drawing test (CDT) was not able to accurately detect people with CDR = 0.5. Other researchers have promoted the use of scoring approaches with multiple scales that rate quantitative and qualitative features of the production. Nevertheless, these scoring systems are complex and time-consuming. We propose a new brief CDT’ scoring system in order to find a good measure for mild cognitive decline which is at the same time easy to administer. we enrolled 719 subjects: n. 181 with mild Alzheimer’s disease (AD); n. 200 with amnesic mild cognitive impairment (MCI) and n. 338 healthy elderly subjects (C). our CDT-three-cluster scoring system demonstrated a good sensitivity and an excellent specificity to discriminate MCI subjects from normal elderly (76 and 84 %, respectively) and an excellent sensitivity and specificity to discriminate patients affected by mild Alzheimer disease (CDR: 1) from normal elderly (91 and 90 %, respectively). We found that CDT’ score = 1.30 discriminate people with MCI, whereas a score = 4.38 discriminate AD patients. The three-cluster-scoring-system demonstrated a good diagnostic accuracy, taking into account those error-items more predictive of cognitive decline: omission of numbers or hands, writing numbers or hands in a wrong position and writing numbers or hands in a different code. Our CDT’ scoring system is very short and easy method which can be used also by non-specialist.

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Authors and Affiliations

  1. ARC Centre of Excellence for Cognition and its Disorders, Macquarie University, Sydney, Australia

    Monica Ricci

  2. Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy

    Martina Pigliautile, Valeria D’Ambrosio, Sara Ercolani, Cinzia Bianchini, Carmelinda Ruggiero & Patrizia Mecocci

  3. National Centre of Epidemiology, National Institute of Health, Rome, Italy

    Nicola Vanacore

Authors
  1. Monica Ricci
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  2. Martina Pigliautile
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  3. Valeria D’Ambrosio
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Correspondence to Monica Ricci.

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Ricci, M., Pigliautile, M., D’Ambrosio, V. et al. The clock drawing test as a screening tool in mild cognitive impairment and very mild dementia: a new brief method of scoring and normative data in the elderly. Neurol Sci 37, 867–873 (2016). https://doi.org/10.1007/s10072-016-2480-6

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