title: Which figure copy test is more sensitive for cognitive impairment in Parkinson's disease: Wire cube or interlocking pentagons?
abstract: BACKGROUND
  Performance on figure copy tests has been shown to predict progressive cognitive decline in Parkinson's disease (PD). Historically, the interlocking pentagons from the Mini Mental State Exam (MMSE) have been the figure copy test most commonly used during cognitive screening evaluations. However, the wire cube from the Montreal Cognitive Assessment (MoCA) is increasingly being used.
  
  
  OBJECTIVE
  To evaluate which of these figure copy tests is more sensitive for cognitive impairment in PD.
  
  
  METHODS
  Sixty-three PD patients from UK and USA completed the MMSE and MoCA. Logistic regression and sensitivity/specificity analyses were used to evaluate the utility of each figure copy test for detecting global cognitive impairment.
  
  
  RESULTS
  The wire cube was a significant indicator of cognitive impairment (OR=4.79, 95% CI=1.63-14.07, p=0.004), with a sensitivity/specificity of 0.74/0.63 in our sample. In contrast, interlocking pentagons were not a significant indicator of cognitive impairment (OR=1.88, 95% CI=0.54-6.50, p=0.32), with a sensitivity/specificity of 0.26/0.84.
  
  
  CONCLUSIONS
  The wire cube is more sensitive to cognitive impairment in PD, most likely related to its greater complexity. The results have implications for clinicians who may have time for just one figure copying task as part of a brief screen for cognitive impairment in busy clinics and for researchers applying the PD mild cognitive impairment diagnostic criteria necessitating two tests of visuospatial function to be administered.
authors.affiliation: University of York, Hull York Medical School, York, UK; Department of Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. Electronic address: jane.alty@hyms.ac.uk.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Alty
authors.affiliation: University of York, Hull York Medical School, York, UK; Department of Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Cosgrove
authors.affiliation: University of York, Hull York Medical School, York, UK; Department of Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: Stuart
authors.initials: S
authors.lastname: Jamieson
authors.affiliation: Department of Electronics, University of York, York, UK.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Smith
authors.affiliation: University of California - San Francisco, USA. Electronic address: kpossin@memory.ucsf.edu.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Possin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D012680:Sensitivity and Specificity; D006113:United Kingdom; D014481:United States
keywords: Cognitive; Cube; Dementia; Parkinson's; Pentagons