Duro Diana, Tábuas-Pereira Miguel, Freitas Sandra, Santiago Beatriz, Botelho Maria Amália, Santana Isabel
1 Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
2 Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
J Geriatr Psychiatry Neurol. 2018 May;31(3):114-122. doi: 10.1177/0891988718774432. Epub 2018 May 9.
The Clock Drawing Test (CDT) has a known potential for the detection of cognitive impairment in populations with dementia, especially Alzheimer disease (AD). Our aim was to compare the clinical utility of 3 CDT scoring systems (Rouleau, Cahn, and Babins) in several pathologies with cognitive compromise from a tertiary center memory clinic. We selected patients with a clinical diagnosis of mild stage AD, behavioral variant frontotemporal dementia (FTD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and Parkinson disease with dementia (PDD). The results showed significant differences between the several diagnoses with the following pattern of results: AD, DLB < FTD, VaD, PDD. Qualitative analysis of clock drawing errors confirmed the stimulus-bound response as a hallmark of AD, while conceptual deficit was significantly more prevalent in patients with AD and DLB. Our results supported the CDT potential as a cognitive screening measure for mild dementia, particularly sensitive to AD and DLB, especially when we used the Cahn scoring system and its analysis of qualitative errors.
画钟试验（CDT）在检测痴呆人群（尤其是阿尔茨海默病（AD））的认知障碍方面具有已知潜力。我们的目的是比较三级中心记忆门诊中3种CDT评分系统（鲁洛、卡恩和巴宾斯）在几种伴有认知损害的病症中的临床效用。我们选择了临床诊断为轻度AD、行为变异型额颞叶痴呆（FTD）、血管性痴呆（VaD）、路易体痴呆（DLB）和帕金森病痴呆（PDD）的患者。结果显示，几种诊断之间存在显著差异，结果模式如下：AD、DLB < FTD、VaD、PDD。对画钟错误的定性分析证实，刺激约束反应是AD的一个标志，而概念缺陷在AD和DLB患者中更为普遍。我们的结果支持了CDT作为轻度痴呆认知筛查措施的潜力，对AD和DLB特别敏感，尤其是当我们使用卡恩评分系统及其对定性错误的分析时。
