시계 그리기의 임상 활용 예비 연구: 알쯔하이머병과 피질하혈관치매에서의 비교
Preliminary Study for Expanding the Clinical Utility of Clock Drawing test: Alzheimer’s Disease vs. Subcortical Vascular Dementia
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Background: This study examines the differences in the types of errors made on the clock drawing test (CDT) by patients with Alzheimer’s disease (AD) or subcortical vascular dementia (SVaD). Methods: The CDT scores of 27 patients with AD, 27 patients with SVaD and 27 healthy elderly subjects were analyzed using twenty-six scoring items. We also investigated which scoring items were more useful in differentiating between the control and dementia groups and between the AD and SVaD groups. Results: Qualitative analysis revealed that 5 of the 26 items (‘closed’, ‘bilateral symmetry’, ‘no same numbers’, ‘all numbers in the circle’, ‘absence of unnecessary mark and word’) were not useful in differentiating between the control and dementia groups. The control and AD groups differed on items related to hands, but almost all of the items could be used to differentiate between the control and SVaD groups. The SVaD group differed from the control group on nearly every item. Qualitative analysis revealed differences in the types of errors on the CDT between AD and SVaD, such as ‘difficulty of drawing’ and ‘spatial-planning deficit’, which could make it possible to differentiate between these two groups, but only in the early stages of these diseases. Moreover, the CDT was more useful in the diagnosis of SVaD than AD. Conclusions: The CDT is a very useful cognitive screening tool. However, it should be interpreted on the basis of error type and education level. Knowledge about the basic mechanism behind each error type can make the CDT a more reliable screening tool.
Abstract
Background: This study examines the differences in the types of errors made on the clock drawing test (CDT) by patients with Alzheimer’s disease (AD) or subcortical vascular dementia (SVaD). Methods: The CDT scores of 27 patients with AD, 27 patients with SVaD and 27 healthy elderly subjects were analyzed using twenty-six scoring items. We also investigated which scoring items were more useful in differentiating between the control and dementia groups and between the AD and SVaD groups. Results: Qualitative analysis revealed that 5 of the 26 items (‘closed’, ‘bilateral symmetry’, ‘no same numbers’, ‘all numbers in the circle’, ‘absence of unnecessary mark and word’) were not useful in differentiating between the control and dementia groups. The control and AD groups differed on items related to hands, but almost all of the items could be used to differentiate between the control and SVaD groups. The SVaD group differed from the control group on nearly every item. Qualitative analysis revealed differences in the types of errors on the CDT between AD and SVaD, such as ‘difficulty of drawing’ and ‘spatial-planning deficit’, which could make it possible to differentiate between these two groups, but only in the early stages of these diseases. Moreover, the CDT was more useful in the diagnosis of SVaD than AD. Conclusions: The CDT is a very useful cognitive screening tool. However, it should be interpreted on the basis of error type and education level. Knowledge about the basic mechanism behind each error type can make the CDT a more reliable screening tool.
참고문헌 (23)
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