title: Is the clock drawing test appropriate for screening for mild cognitive impairment?--Results of the German study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe).
abstract: BACKGROUND
  Individuals with mild cognitive impairment (MCI) are at high risk of developing dementia and are a target group for preventive interventions. Therefore, research aims at diagnosing MCI at an early stage with short, simple and easily administrable screening tests. Due to the fact that the Clock Drawing Test (CDT) is widely used to screen for dementia, it is questionable whether it is suited to screen for MCI.
  
  
  METHODS
  3,198 primary care patients aged 75+ were divided into two groups according to their cognitive status, assessed by comprehensive neuropsychological testing: individuals without MCI and individuals with MCI. The CDT scores, evaluated by the scoring system of Sunderland et al. [J Am Geriatr Soc 1989;37:725-729], of both groups were compared. Multivariate analyses were calculated and the sensitivity and specificity of the CDT to screen for MCI were reported.
  
  
  RESULTS
  Significant differences were found for CDT results: MCI patients obtained worse results than cognitively unimpaired subjects. CDT has a significant impact on the diagnosis of MCI. However, sensitivity and specificity as well as receiver operating characteristic analyses are not adequate, meaning that the CDT could not be named as an exact screening tool.
  
  
  CONCLUSIONS
  Applying different CDT versions of administration and scoring could yield different results.
  
  
  CONCLUSIONS
  CDT does not achieve the quality to screen individuals for MCI.
authors.affiliation: Department of Psychiatry, University of Leipzig, Leipzig, Germany. Lena.Ehreke@medizin.uni-leipzig.de
authors.forename: Lena
authors.initials: L
authors.lastname: Ehreke
authors.forename: Melanie
authors.initials: M
authors.lastname: Luppa
authors.forename: Tobias
authors.initials: T
authors.lastname: Luck
authors.forename: Birgitt
authors.initials: B
authors.lastname: Wiese
authors.forename: Siegfried
authors.initials: S
authors.lastname: Weyerer
authors.forename: Sandra
authors.initials: S
authors.lastname: Eifflaender-Gorfer
authors.forename: Dagmar
authors.initials: D
authors.lastname: Weeg
authors.forename: Julia
authors.initials: J
authors.lastname: Olbrich
authors.forename: Hendrik
authors.initials: H
authors.lastname: van den Bussche
authors.forename: Cadja
authors.initials: C
authors.lastname: Bachmann
authors.forename: Marion
authors.initials: M
authors.lastname: Eisele
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Frank
authors.initials: F
authors.lastname: Jessen
authors.forename: Michael
authors.initials: M
authors.lastname: Wagner
authors.forename: Angela
authors.initials: A
authors.lastname: Fuchs
authors.forename: Michael
authors.initials: M
authors.lastname: Pentzek
authors.forename: Matthias C
authors.initials: MC
authors.lastname: Angermeyer
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology*; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology*; D015161:Dementia, Multi-Infarct / Q000175:diagnosis / Q000523:psychology; D056344:Executive Function / Q000502:physiology; D005260:Female; D005858:Germany; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards*; D010361:Patients; D011320:Primary Health Care; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D015203:Reproducibility of Results