경도 치매와 노인성 우울의 변별을 위한 시계 그리기 검사의 효율성
The Efficiency of the Clock Drawing Test for Differentiating Mild Dementia from Geriatric Depression
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초록
본 연구에서는 경도 치매와 노인성 우울 및 정상 노인을 변별하는 검사로서 CDT의 효율성을 알아볼 목적으로 수행되었다. 경도의 치매환자로 진단된 25명의 환자들과 연령, 교육수준 및 성별을 균등화시킨 노인성 우울로 진단된 25명의 환자들 그리고 정상 노인 25명에게 시계 그리기 검사를 실시하였다. 자료분석에서는 절단점수, 효율성, 민감도, 특이도, +LR 및 -LR이 산출되었고, 각 그림에 대한 오류 유형도 분석되었다. 경도 치매집단의 CDT 점수는 노인성 우울집단과 정상 노인집단에 비해 유의하게 낮았다. CDT는 경도 치매집단과 정상 노인집단, 경도 치매집단과 노인성 우울집단은 잘 변별하였으나 노인성 우울집단과 정상 노인집단은 잘 변별하지 못하였다. 오류유형 분석 결과, 경도 치매집단은 노인성 우울집단이나 정상 노인집단에 비해 자극-속박반응, 개념결함, 공간과 계획오류가 더 많이 나타났다. 끝으로, 본 연구의 시사점, 제한점 및 향후 연구방향이 논의되었다.
Abstract
The purpose of this study was to examine the efficiency of the Clock Drawing Test(CDT) for differentiating mild dementia from geriatric depression and normal elderly person. The CDT was administered to 25 patients with clinically diagnosed mild dementia, 25 with geriatric depression and 25 normal control and these groups were similar in age, education and gender. The cut-off scores, efficiencies, sensitivities, specificities, positive likelihood ratio and negative likelihood ratio of each group were calculated and then the analysis of error type was conducted. CDT significantly discriminated mild dementia patients from geriatric depression patients or normal controls but could not discriminate geriatric depression patients from normal controls. In the error type analysis of clock drawing, 'stimulus bound response', 'conceptual error' and 'spatial and planning error' were more frequent in patients with mild dementia than in normal controls or in geriatric depression patients. Finally, the suggestions, limitations and further issues for future study were discussed.
참고문헌 (41)
- "치매의 신경심리학적 평가: 삼성신경심리학검사(SNSB)." (1999)
- "한국판 보스톤 이름대기 검사(K-BNT)." (1997), 학지사.
- "노인정신의학" (1998), 중앙문화사
- "경도 알쯔하이머형 치매 환자와 우울증 환자의 신경심리기능 및 신경심리학적 변별", 19(1), pp.131~150 (2000)
- "노인의 우울에 관한 연구", 4, pp.44~52 (1984)
- "치매, 주요우울장애 및 주정의존에서 7분선별검사를 이용한 인지장애의 비교.", 5(1), pp.67~75 (2001)
- "노인 우울 척도(Geriatric Depression Scale)의 신뢰도, 타당도 연구.", 36(1), pp.103~112 (1997)
- "한국판 expanded clinical dementia rating(CDR) 척도의 타당도", 19(6), pp.585~591 (2001)
- "치매 선별 검사로서 시계 그리기 검사의 효율성", 20(3), pp.519~533 (2001)
- "Neuropsychological deficits and CT scan changes in elderly depressives", pp.507~520 (1990)
- "The Clock-drawing test", 27, pp.399~404 (1998)
- "Effect of education on the clock-drawing dementia screen in non-demented elderly patients", 41, pp.249~252 (1993)
- "Diagnostic and statistical manual of mental disorders" (1994)
- "Objective screening tools to assess cognitive impairment and depression", 18, pp.28~46 (2002)
- "Reduction of prefrontal cortex glucose metabolism common to three types of depression Archives of General Psychiatry", pp.243~250 (1989)
- "Differential perceptual-spatial impairment in Huntington's and Alzheimer's dementias Archives of Neurology", pp.1073~1076 (1984)
- "Clinical guidelines in old age psychiatry" (2002), Martin Dunitz.
- "Screening for dementia of the Alzheimer Type in the community: The utility of the clock drawing test", 11, pp.529~539 (1996)
- "Pseudo-dementia", 38, pp.1359~1364 (1981)
- "Textbook of geriatric neuropsychiatry(2nd ed.)." (2000), American Psychiatric Press
- "Positron emission tomography in the evaluation of dementia" (2001), http:
- "CT measurement of medial temporal lobe atrophy in Alzheimer's disease, vascular dementia, depression and paraphrenia.", 15, pp.306~312 (2000)
- "Neuropsychological assessment of neuropsychiatric disorders(2nd ed.)." (1996), Oxford University Press.
- "A comparison of the clock drawing test and the Pheiffer short portable mental status questionnaire in a geropsychiatry clinic.", 12, pp.526~532 (1997)
- "Clock tests in depression, Alzheimer's disease, and elderly controls.", 28, pp.437~447 (1998)
- "A new clinical scale for the staging of dementia British Journal of Psychiatry", pp.566~572 (1982)
- "Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences, clinical psychiatry(8th ed.)." (1998), Williams & Wilkins.
- "Differential diagnosis of dementia and depression Neuropsychological assessment of dementia and depression in older adults" (1994)
- "The clock drawing test in primary care: Sensitivity in dementia detection and specificity against normal and depressed elderly", 16, pp.935~940 (2001)
- "Patterns of cerebral glucose utilization in Parkinson's disease and Huntington's disease Annals of Neurology", pp.119~125 (1984)
- "State-dependent nature of the clock drawing task in geriatric depression.", 43, pp.796~798 (1995)
- "Selective hypometabolism in the inferior frontal lobe in depressed patients with Parkinson's disease Annal of Neurology", pp.57~64 (1990)
- "Longitudinal analysis of clock drawing in Alzheimer's disease patients.", 31, pp.17~34 (1996)
- "Quantitative and qualitative analyses of clock drawings in Alzheimer's and Huntington's disease", pp.70~87 (1992), Brain & Cognition
- "A 7 minute neurocognitive screening battery highly sensitive to Alzheimer's disease.", 55, pp.349~355 (1998)
- "A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary(2nd ed.).", (rms) (1998), Oxford University Press
- "Clock-drawing: Is it the ideal cognitive screening test?", 15, pp.548~561 (2000)
- "Clock drawing in Alzheimer's disease a novel measure of dementia severity Journal of the American Geriatric Society", pp.725~729 (1989)
- "Screening for Alzheimer's disease by clock drawing Journal of American Geriatric Society", pp.730~734 (1989)
- "Development and validation of a geriatric depression screening scale Journal of Psychiatry & Research", pp.37~49 (1983)
- "Development and validation of a geriatric depression screening scale Journal of Psychiatry & Research", pp.37~49 (1983)