Clock-drawing Test and Cube-copying Test to Quickly Screen Dementia: In Combination with the Mini-mental State Examination Scores

Objective Due to the increasing elderly population and number of dementia patients, the current number of psychiatrists and neurologists remains insufficient to treat dementia in Japan. Therefore, a simple method for accurately performing a dementia diagnosis, including that of primary care physicia...

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Veröffentlicht in:Internal Medicine 2024/05/01, Vol.63(9), pp.1223-1228
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description Objective Due to the increasing elderly population and number of dementia patients, the current number of psychiatrists and neurologists remains insufficient to treat dementia in Japan. Therefore, a simple method for accurately performing a dementia diagnosis, including that of primary care physicians, is sought in clinical practice. Methods A retrospective study was conducted on patients who made their first visit due to amnesia between October 2020 and October 2022. The sensitivities and specificities of four spatial recognition and planning ability evaluation methods [fox finger imitation test, pentagon-copying test (PCT), cube-copying test (CCT), and clock-drawing test (CDT)] were calculated. The difference between the Mini-mental State Examination (MMSE) scores, as an evaluation of memory and language impairment, and CDT scores were assessed using the Mann-Whitney U test. Patients Fifty-one patients with dementia and 6 patients without dementia were examined in this study. Results The sensitivity and specificity were 31.4% and 100% for the fox finger imitation tests, 29.4% and 100% for PCT, 62% and 83.3% for CCT, and 72.5% and 100% for CDT, respectively. The sensitivity increased to 78.4% when the CCT and CDT results were combined. Spearman's rank correlation coefficient between the MMSE and CDT scores of the 51 patients with dementia showed a significantly positive correlation (r=0.62, p
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Therefore, a simple method for accurately performing a dementia diagnosis, including that of primary care physicians, is sought in clinical practice. Methods A retrospective study was conducted on patients who made their first visit due to amnesia between October 2020 and October 2022. The sensitivities and specificities of four spatial recognition and planning ability evaluation methods [fox finger imitation test, pentagon-copying test (PCT), cube-copying test (CCT), and clock-drawing test (CDT)] were calculated. The difference between the Mini-mental State Examination (MMSE) scores, as an evaluation of memory and language impairment, and CDT scores were assessed using the Mann-Whitney U test. Patients Fifty-one patients with dementia and 6 patients without dementia were examined in this study. Results The sensitivity and specificity were 31.4% and 100% for the fox finger imitation tests, 29.4% and 100% for PCT, 62% and 83.3% for CCT, and 72.5% and 100% for CDT, respectively. The sensitivity increased to 78.4% when the CCT and CDT results were combined. Spearman's rank correlation coefficient between the MMSE and CDT scores of the 51 patients with dementia showed a significantly positive correlation (r=0.62, p&lt;0.001). Comparing Alzheimer's disease (AD) and dementia with Lewy bodies (DLB), the difference between the MMSE and CDT scores was significantly greater in patients with DLB. Conclusion To quickly screen for dementia, a combination of CCT and CDT is recommended for the highest sensitivity (78.4%). In addition, the difference between the CDT and MMSE scores is considered to be useful for differentiating DLB from AD.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.2579-23</identifier><identifier>PMID: 37779058</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>Aged ; Aged, 80 and over ; Alzheimer's disease ; Amnesia ; clock-drawing test ; cube-copying test ; Dementia ; Dementia - diagnosis ; Dementia disorders ; dementia with Lewy bodies ; Female ; fox finger imitation test ; Humans ; Japan ; Lewy bodies ; Male ; Mental Status and Dementia Tests - standards ; Neurodegenerative diseases ; Neuropsychological Tests - standards ; Original ; Primary care ; Retrospective Studies ; Sensitivity and Specificity</subject><ispartof>Internal Medicine, 2024/05/01, Vol.63(9), pp.1223-1228</ispartof><rights>2024 by The Japanese Society of Internal Medicine</rights><rights>2024. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2024 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c586t-fbb07251657bdcff304c1327ee9886f194f9faa4a8cd5fae95d02d7f4ef347d53</citedby><cites>FETCH-LOGICAL-c586t-fbb07251657bdcff304c1327ee9886f194f9faa4a8cd5fae95d02d7f4ef347d53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11116009/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11116009/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,1876,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37779058$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Higaki, Yuji</creatorcontrib><title>Clock-drawing Test and Cube-copying Test to Quickly Screen Dementia: In Combination with the Mini-mental State Examination Scores</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>Objective Due to the increasing elderly population and number of dementia patients, the current number of psychiatrists and neurologists remains insufficient to treat dementia in Japan. Therefore, a simple method for accurately performing a dementia diagnosis, including that of primary care physicians, is sought in clinical practice. Methods A retrospective study was conducted on patients who made their first visit due to amnesia between October 2020 and October 2022. The sensitivities and specificities of four spatial recognition and planning ability evaluation methods [fox finger imitation test, pentagon-copying test (PCT), cube-copying test (CCT), and clock-drawing test (CDT)] were calculated. The difference between the Mini-mental State Examination (MMSE) scores, as an evaluation of memory and language impairment, and CDT scores were assessed using the Mann-Whitney U test. Patients Fifty-one patients with dementia and 6 patients without dementia were examined in this study. Results The sensitivity and specificity were 31.4% and 100% for the fox finger imitation tests, 29.4% and 100% for PCT, 62% and 83.3% for CCT, and 72.5% and 100% for CDT, respectively. The sensitivity increased to 78.4% when the CCT and CDT results were combined. Spearman's rank correlation coefficient between the MMSE and CDT scores of the 51 patients with dementia showed a significantly positive correlation (r=0.62, p&lt;0.001). Comparing Alzheimer's disease (AD) and dementia with Lewy bodies (DLB), the difference between the MMSE and CDT scores was significantly greater in patients with DLB. Conclusion To quickly screen for dementia, a combination of CCT and CDT is recommended for the highest sensitivity (78.4%). In addition, the difference between the CDT and MMSE scores is considered to be useful for differentiating DLB from AD.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alzheimer's disease</subject><subject>Amnesia</subject><subject>clock-drawing test</subject><subject>cube-copying test</subject><subject>Dementia</subject><subject>Dementia - diagnosis</subject><subject>Dementia disorders</subject><subject>dementia with Lewy bodies</subject><subject>Female</subject><subject>fox finger imitation test</subject><subject>Humans</subject><subject>Japan</subject><subject>Lewy bodies</subject><subject>Male</subject><subject>Mental Status and Dementia Tests - standards</subject><subject>Neurodegenerative diseases</subject><subject>Neuropsychological Tests - standards</subject><subject>Original</subject><subject>Primary care</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkVFvFCEUhSdGY7fVv2BIfPFlKgPDMPhizFq1SdWYrc-EYS67bGdgC4x1H_vPZbPbjVYeLgl893C4pyhQhc9J1Yi31iUITg0j9FZbB-eEcVES-qSYVbQWJSeUPS1mWFRtSXI5KU5jXGNMWy7I8-KEcs4FZu2suJ8PXt-UfVB31i3RNcSElOvRfOqg1H6zPZ4mj35MVt8MW7TQAcChjzCCS1a9Q5cOzf3YWaeS9Q7d2bRCaQXoq3W23EFqQIukEqCL32p8wBbaB4gvimdGDRFeHvaz4ueni-v5l_Lq--fL-YerUrO2SaXpOswJqxrGu14bQ3GtK0o4gGjbxlSiNsIoVatW98woEKzHpOemBkNr3jN6Vrzf626mLs9NZ1dBDXIT7KjCVnpl5b83zq7k0v-SVV4NxiIrvDkoBH875ZnI0UYNw6Ac-ClK0vJsj9V1ndHXj9C1n3aJRUkxqxshSIsz1e4pHXyMAczRTYXlLmj5OGi5C1oSmltf_f2bY-NDshn4tgfWMaklHAEVktUD_K_cUCl25fDCEdQrFSQ4-gfyL8mN</recordid><startdate>20240501</startdate><enddate>20240501</enddate><creator>Higaki, Yuji</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240501</creationdate><title>Clock-drawing Test and Cube-copying Test to Quickly Screen Dementia: In Combination with the Mini-mental State Examination Scores</title><author>Higaki, Yuji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c586t-fbb07251657bdcff304c1327ee9886f194f9faa4a8cd5fae95d02d7f4ef347d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alzheimer's disease</topic><topic>Amnesia</topic><topic>clock-drawing test</topic><topic>cube-copying test</topic><topic>Dementia</topic><topic>Dementia - diagnosis</topic><topic>Dementia disorders</topic><topic>dementia with Lewy bodies</topic><topic>Female</topic><topic>fox finger imitation test</topic><topic>Humans</topic><topic>Japan</topic><topic>Lewy bodies</topic><topic>Male</topic><topic>Mental Status and Dementia Tests - standards</topic><topic>Neurodegenerative diseases</topic><topic>Neuropsychological Tests - standards</topic><topic>Original</topic><topic>Primary care</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Higaki, Yuji</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Higaki, Yuji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clock-drawing Test and Cube-copying Test to Quickly Screen Dementia: In Combination with the Mini-mental State Examination Scores</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2024-05-01</date><risdate>2024</risdate><volume>63</volume><issue>9</issue><spage>1223</spage><epage>1228</epage><pages>1223-1228</pages><artnum>2579-23</artnum><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>Objective Due to the increasing elderly population and number of dementia patients, the current number of psychiatrists and neurologists remains insufficient to treat dementia in Japan. Therefore, a simple method for accurately performing a dementia diagnosis, including that of primary care physicians, is sought in clinical practice. Methods A retrospective study was conducted on patients who made their first visit due to amnesia between October 2020 and October 2022. The sensitivities and specificities of four spatial recognition and planning ability evaluation methods [fox finger imitation test, pentagon-copying test (PCT), cube-copying test (CCT), and clock-drawing test (CDT)] were calculated. The difference between the Mini-mental State Examination (MMSE) scores, as an evaluation of memory and language impairment, and CDT scores were assessed using the Mann-Whitney U test. Patients Fifty-one patients with dementia and 6 patients without dementia were examined in this study. Results The sensitivity and specificity were 31.4% and 100% for the fox finger imitation tests, 29.4% and 100% for PCT, 62% and 83.3% for CCT, and 72.5% and 100% for CDT, respectively. The sensitivity increased to 78.4% when the CCT and CDT results were combined. Spearman's rank correlation coefficient between the MMSE and CDT scores of the 51 patients with dementia showed a significantly positive correlation (r=0.62, p&lt;0.001). Comparing Alzheimer's disease (AD) and dementia with Lewy bodies (DLB), the difference between the MMSE and CDT scores was significantly greater in patients with DLB. Conclusion To quickly screen for dementia, a combination of CCT and CDT is recommended for the highest sensitivity (78.4%). In addition, the difference between the CDT and MMSE scores is considered to be useful for differentiating DLB from AD.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>37779058</pmid><doi>10.2169/internalmedicine.2579-23</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Aged, 80 and over
Alzheimer's disease
Amnesia
clock-drawing test
cube-copying test
Dementia
Dementia - diagnosis
Dementia disorders
dementia with Lewy bodies
Female
fox finger imitation test
Humans
Japan
Lewy bodies
Male
Mental Status and Dementia Tests - standards
Neurodegenerative diseases
Neuropsychological Tests - standards
Original
Primary care
Retrospective Studies
Sensitivity and Specificity
title Clock-drawing Test and Cube-copying Test to Quickly Screen Dementia: In Combination with the Mini-mental State Examination Scores
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