title: Development of the four-item Letter and Shape Drawing test (LSD-4): A brief bedside test of visuospatial function.
abstract: Conventional bedside tests of visuospatial function such as the Clock Drawing (CDT) and Intersecting Pentagons (IPT) lack consistency in delivery and interpretation. We compared performance on a novel test of visuospatial ability - the LSD - with the IPT, CDT and MMSE in 180 acute elderly medical inpatients [mean age 79.7±7.1 (range 62-96); 91 females (50.6%)]. 124 (69%) scored ≤23 on the MMSE; 60 with mild (score 18-23) and 64 with severe (score ≤17) impairment. 78 (43%) scored ≥6 on the CDT, while for the IPT, 87 (47%) scored ≥4. The CDT and IPT agreed on the classification of 138 patients (77%) with modest-strong agreement with the MMSE categories. Correlation between the LSD and visuospatial tests was high. A four-item version of the LSD incorporating items 1,10,12,15 had high correlation with the LSD-15 and strong association with MMSE categories. The LSD-4 provides a brief and easily interpreted bedside test of visuospatial function that has high coverage of elderly patients with neurocognitive impairment, good agreement with conventional tests of visuospatial ability and favourable ability to identify significant cognitive impairment. [181 words].
authors.affiliation: Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland; Department of Psychiatry, University Hospital Limerick, Ireland.
authors.forename: Olugbenga Alaba
authors.initials: OA
authors.lastname: Williams
authors.affiliation: Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland; Laois-Offaly Mental Health services, St Fintan's Hospital, Portlaoise, Ireland.
authors.forename: Henry
authors.initials: H
authors.lastname: O'Connell
authors.affiliation: Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland.
authors.forename: Maeve
authors.initials: M
authors.lastname: Leonard
authors.affiliation: Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland.
authors.forename: Fahad
authors.initials: F
authors.lastname: Awan
authors.affiliation: Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland.
authors.forename: Debbie
authors.initials: D
authors.lastname: White
authors.affiliation: Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland.
authors.forename: Frank
authors.initials: F
authors.lastname: McKenna
authors.affiliation: Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland.
authors.forename: Ailish
authors.initials: A
authors.lastname: Hannigan
authors.affiliation: Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland; Department of General Practice, School of Medicine, University College Dublin, Ireland.
authors.forename: Walter
authors.initials: W
authors.lastname: Cullen
authors.affiliation: Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland.
authors.forename: Chris
authors.initials: C
authors.lastname: Exton
authors.affiliation: Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland; Laois-Offaly Mental Health services, St Fintan's Hospital, Portlaoise, Ireland.
authors.forename: Walter
authors.initials: W
authors.lastname: Enudi
authors.affiliation: Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland.
authors.forename: Colum
authors.initials: C
authors.lastname: Dunne
authors.affiliation: Graduate Entry Medical School, University of Limerick, Ireland; Sligo Mental Health Services, Ballytivan Road, Sligo, Ireland.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Adamis
authors.affiliation: Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland; Department of Psychiatry, University Hospital Limerick, Ireland. Electronic address: david.meagher@ul.ie.
authors.forename: David
authors.initials: D
authors.lastname: Meagher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D000067716:Point-of-Care Testing; D015203:Reproducibility of Results; D065855:Spatial Processing
keywords: Assessment Letter and Shape Drawing Test (LSD); Cognition; Phenomenology