Jundiaí Medical School, Jundiaí, Brazil.
Am J Alzheimers Dis Other Demen. 2012 Dec;27(8):620-4. doi: 10.1177/1533317512463954. Epub 2012 Nov 1.
The aim of this study was to describe the performance in Clock Drawing Test (CDT) of the elderly individuals assessed in a geriatric clinic, with at least 1 year of schooling, comparing with other groups with higher education and with Clinical Dementia Rating (CDR) levels. The study also aims to correlate the results of CDT and other used diagnostic tests for dementia by CDR levels, providing additional validity evidence to the CDT.
Cross-sectional study with 426 elderly individuals, >60 years old and at least 1 year of education. All participants searched for medical assistance at Geriatric and Gerontology Ambulatory of Jundiaí city, in Brazil. The community-dwelling outpatients previously undergone a detailed clinical examination and neuropsychological evaluation: Cambrigde Cognitive Examination (CAMCOG), Mini-Mental State Examination (MMSE), andCDT. To differentiate data from diagnostic groups based on CDR, it Kruskal-Wallis test was used. Pearson statistics were calculated to compare data from CDT and CDR. The statistical analyses were 2-tailed and were considered significant when P < .05.
Regarding CDT, groups with more years of schooling showed similar means in CDR = 0 and CDR = 0.5 and in CDR = 1 and CDR = 2. Shulman and Sunderland scale were high score in groups with more years of education and above of cutoff points in all CDT score. On the contrary, in Mendez scale we did not observed similar means. Otherwise, in the group with less years of schooling greater means differences in the CDT were observed.
The CDT did not show a strong correlation with MMSE and CAMCOG, both important instruments in Brazilian population to investigate dementia. For elderly individuals with high education levels, the CDT did not seem to be a good test to detect cognitive impairment.
本研究旨在描述在老年诊所评估的具有至少 1 年受教育年限的老年个体在画钟测验（CDT）中的表现，并与其他具有更高教育程度的群体和临床痴呆评定量表（CDR）级别进行比较。该研究还旨在通过 CDR 级别对 CDT 与其他用于痴呆诊断的测试结果进行相关性分析，为 CDT 提供额外的有效性证据。
这是一项横断面研究，共纳入 426 名年龄在 60 岁以上且至少接受过 1 年教育的老年人。所有参与者均在巴西 Jundiaí 的老年医学和老年学门诊寻求医疗帮助。社区居住的门诊患者之前接受了详细的临床检查和神经心理评估：剑桥认知测验（CAMCOG）、简易精神状态检查（MMSE）和 CDT。为了根据 CDR 区分诊断组的数据，使用了 Kruskal-Wallis 检验。计算 Pearson 统计数据以比较 CDT 和 CDR 的数据。统计分析为双侧，当 P<.05 时认为差异具有统计学意义。
在 CDT 方面，受教育年限较长的组在 CDR=0 和 CDR=0.5 以及 CDR=1 和 CDR=2 时具有相似的平均值。Shulman 和 Sunderland 量表在受教育程度较高的组中得分较高，且在所有 CDT 得分的截点之上。相反，在 Mendez 量表中，我们没有观察到相似的平均值。另一方面，在受教育年限较短的组中，CDT 的平均差异较大。
CDT 与 MMSE 和 CAMCOG 均无显著相关性，而这两项测试在巴西人群中都是用于痴呆症调查的重要工具。对于教育程度较高的老年个体，CDT 似乎不是检测认知障碍的好方法。
