Manos P J, Wu R
Section of Psychiatry and Psychology Virginia Mason Medical Center, Seattle, WA 98111.
Int J Psychiatry Med. 1994;24(3):229-44. doi: 10.2190/5A0F-936P-VG8N-0F5R.
The objective of this study was to evaluate the clinical utility of the ten point clock test in screening for and grading cognitive deficits in medical and surgical patients.
The setting was the hospital and clinics of Virginia Mason Medical Center, a tertiary referral center. Consecutive samples of hospitalized patients, and clinic outpatients--with and without a dementia--were administered the ten point clock test as well as a number of other neuropsychological tests and measures of cognitive impairment.
Clock scores correlated with neuropsychological test scores and with the mini-mental state examination. They were stable from rater to rater, and from day to day in stable patients. The mean clock score of elderly outpatient controls was 8.5, significantly different from the mean of 5.5 scored by patients with a dementia. A cut off score of seven identified 76 percent of outpatients with dementia and 78 percent of elderly controls. Clock scores correlated well with nurses' ratings of their inpatients' cognitive deficits (Spearman's rs = -0.61). The test was easy to administer, even to hospitalized patients.
The ten point clock test is reliable, valid, and useful as a quick screen and grading method for cognitive deficits in medical and surgical patients.
本研究的目的是评估十点时钟测试在筛查和分级内科及外科患者认知缺陷方面的临床效用。
研究地点为弗吉尼亚梅森医疗中心的医院和诊所，这是一家三级转诊中心。对住院患者以及门诊患者的连续样本——无论有无痴呆症——进行十点时钟测试以及其他一些神经心理学测试和认知障碍测量。
时钟测试得分与神经心理学测试得分以及简易精神状态检查相关。在不同评分者之间以及病情稳定的患者中，得分每日稳定。老年门诊对照组的平均时钟测试得分为8.5，与痴呆症患者平均得分5.5有显著差异。截断分数为7时，可识别出76%的痴呆门诊患者和78%的老年对照组。时钟测试得分与护士对住院患者认知缺陷的评分相关性良好（斯皮尔曼等级相关系数rs = -0.61）。该测试易于实施，即使对住院患者也是如此。
十点时钟测试作为内科及外科患者认知缺陷的快速筛查和分级方法，是可靠、有效的且有用的。
