Does the clock drawing test predict dementia? Results of the Leipzig longitudinal study of the aged (LEILA 75+).
OBJECTIVE
Conversion rates to dementia are known to be high for patients with mild cognitive impairment (MCI), but the diagnosis of MCI is very time-consuming. Since the Clock Drawing Test (CDT) is quick to administer, it will be of interest to compare the predictive validity of the CDT and of an MCI diagnosis for the diagnosis of dementia.


METHODS
In a sample of 384 individuals, CDT scores and the presence of MCI were assessed at baseline and then compared between individuals with an incident dementia diagnosis at follow-up and those without. Multivariate analyses, receiver operating characteristic analyses and values of sensitivity and specificity of the CDT were performed.


RESULTS
Individuals with incident dementia had significantly higher CDT scores at baseline than those without dementia. CDT was a significant predictor of incident dementia after adjusting for other factors. CDT reached a sensitivity of 68% and specificity of 65%. The area under the receiver operating characteristic curve of CDT was 0.70 and therefore slightly lower than for MCI diagnosis (0.78).


CONCLUSIONS
Because of the only slightly lower predictive value of the CDT, its quick application and scoring compared to the MCI concept applied, it will be worthwhile to improve the CDT scoring system in order to increase the predictive validity in dementia.
Public Health Research Unit, Department of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany. Lena.Ehreke@medizin.uni-leipzig.de
Lena
L
Ehreke
Melanie
M
Luppa
Hans-Helmut
HH
König
Arno
A
Villringer
Steffi G
SG
Riedel-Heller
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004522:Educational Status; D005260:Female; D005858:Germany; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status; D008569:Memory Disorders / Q000523:psychology; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012372:ROC Curve; D012044:Regression Analysis; D015203:Reproducibility of Results; D012959:Socioeconomic Factors