Lowery Natasha, Giovanni Lauren, Mozley Lyn Harper, Arnold Steven E, Bilker Warren B, Gur Raquel E, Moberg Paul J
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
Am J Geriatr Psychiatry. 2003 Nov-Dec;11(6):621-8. doi: 10.1176/appi.ajgp.11.6.621.
The authors sought to examine the usefulness of the clock-drawing test (CDT) as a measure of general cognitive and adaptive functioning in elderly patients with schizophrenia.
CDT performance of elderly institutionalized patients with schizophrenia were contrasted with a comparison group, similar in age. Cognitive and functional status was examined using an expanded battery from the Consortium to Establish a Registry for Alzheimer's disease and the Psychogeriatric Dependency Rating Scale.
Patients (N=21) performed more poorly overall on the CDT than the comparison group (N=21), with greater clock number and hand errors. Production of the clock's gestalt did not differ between groups. In patients, overall CDT performance and clock hand placement were significantly correlated with general cognitive functioning, memory, visuoconstruction, and word-list generation. CDT global and hand placement performances corresponded to patients' general orientation.
Impaired CDT performance in elderly patients with schizophrenia is not attributable to normal aging. Also, the CDT uniquely relates to an array of cognitive abilities in this population, validating its multicognitive character and implicating multiple brain regions. The CDT's tolerability and brevity make it attractive for use in geriatric schizophrenia.
作者试图检验画钟试验（CDT）作为评估老年精神分裂症患者一般认知和适应性功能指标的效用。
将老年住院精神分裂症患者的CDT表现与年龄相仿的对照组进行对比。使用来自阿尔茨海默病注册协会扩展版测试组合以及老年精神科依赖评定量表对认知和功能状态进行检查。
患者组（N = 21）在CDT上的总体表现比对照组（N = 21）更差，画钟数字和指针的错误更多。两组在钟的整体形状绘制方面没有差异。在患者中，CDT的总体表现和指针放置与一般认知功能、记忆、视觉构建及单词表生成显著相关。CDT的整体及指针放置表现与患者的一般定向能力相符。
老年精神分裂症患者CDT表现受损并非归因于正常衰老。此外，CDT与该人群的一系列认知能力独特相关，证实了其多认知特性并涉及多个脑区。CDT的耐受性和简洁性使其在老年精神分裂症患者中具有应用吸引力。
