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Quantitative and Qualitative Analyses of Clock Drawings in Mild Cognitive Impairment and Alzheimer's Disease

  • Clinical Psychology in Korea: Research and Practice
  • 2018, 4(1), pp.109-130
  • DOI : 10.15842/CPKJOURNAL.PUB.4.1.109
  • Publisher : Korean Clinical Psychology Association
  • Research Area : Social Science > Psychological Science > Clinical Psychology
  • Received : November 29, 2017
  • Accepted : February 7, 2018

HANA JEONG 1 Ju Hee Chin 1 Hee Jin Kim 1 SEO, SANG WON 1 NA, DUK LYUL ORD ID 1

1삼성서울병원

Candidate

ABSTRACT

The clock drawing test (CDT) has been consistently used as part of neuropsychological assessment, specifically as a screening tool for dementia. This study compared the quantitative and qualitative performance on the CDT among patients with amnestic mild cognitive impairment (aMCI), very mild Alzheimer's disease (AD) with a clinical dementia rating (CDR) of 0.5, and mild AD with a CDR of 1. Ninety-seven subjects with aMCI, 37 subjects with AD-CDR 0.5, and 50 subjects with AD-CDR 1, who visited the Memory Disorders Clinic in the Department of Neurology at the general hospital located in Seoul, underwent CDT and standardized neuropsychological battery tests. Although significant differences were found in the total quantitative scores among the three patient groups, there were no significant differences between aMCI and AD-CDR 0.5 patients. However, the qualitative error analysis revealed differences between the two groups in several areas: misrepresentation of clock (conceptual deficit error), deficit in spatial layout of numbers without any specific pattern (spatial disorganization), and moderate graphic difficulty. In correlational analysis between the CDT and other neuropsychological measures, the CDT was significantly correlated with the Korean-Boston Naming Test, Rey-Osterrieth Complex Figure copying test, verbal/visual memory tests, and frontal/executive function tests. Therefore, the findings of this study suggested that the characteristics of qualitative errors in the CDT can help identify cognitive changes in the early stage of AD; however, the quantitative scores of the CDT revealed limited information about these changes. Additionally, our results indicated that performance in the CDT was associated with semantic knowledge, visuospatial function, and executive function

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