Br J Clin Psychol. CAMCOG--a concise neuropsychological test to assist dementia diagnosis: socio-demographic determinants in an elderly population sample. It was administered to a population sample of elderly people aged 77 and above in their place of residence. Examination of the association between CAMCOG scores and socio-demographic variables age, sex, education and social class shows that each exerts a significant, and independent, effect upon performance. Of the eight major subscales orientation, language, memory, attention, praxis, calculation, abstract thinking, perception , age was significantly related to all but attention; sex with attention, praxis, calculation and perception; education with language and abstract thinking; and social class with language and perception.
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Read doi In this patient population, these cognitive tests may be interchangeable for providing an initial objective measure of cognitive function. This trend became even more conspicuous in the ND group, where some of the above mentioned correlations became non-significant. All rights reserved. Heinik et al. In fact, several investigators suggest that the accuracy of some CDTs is modest at best Storey et al.
Eventhough correlations alone, in this field, are concerned only with relationship without reference to other psychometric properties e. In clinical practice, the clinician at the specialized psychogeriatric ambulatory setting has many tests of cognitive impairment at his disposal Burns et al. Some are short and easy to score, e. As is the case with general practitioners, specialist clinic diagnosticians are pressed for time.
In addition, they also might consider the administration of one test at one stage of the assessment process, and another test at another stage based on the continuously changing clinical information gathered. Since even the most complex-to-score CDT is about a 2 min task Burns et al. A literature survey provided inconclusive data regarding correlations studies. Several replication and other studies show similar results Ben-Yehuda et al.
Methods One hundred and fourteen community-dwelling outpatients were included in the study. Patient evaluation and the methods used have been described elsewhere Heinik et al. Each patient underwent a comprehensive multi-disciplinary psychiatric and medical assessment. The first encounter with the patient was conducted by a geriatric psychiatrist who was also responsible for the administration of the CAMCOG Roth et al. Hebrew versions of both tests were validated Heinik et al.
Laboratory investigations, including imaging studies, were conducted in each case to exclude potentially treatable causes for cognitive impairment and physical causes for the emotional disorders.
One point is given respectively for correctly drawing a circle, placement of the numbers in the correct position, and setting the hands at the correct time The maximum score is therefore three. The latter outlines the following clock drawing components-- contour: two points, numbers: six points, hands: six points, center: one point. Altogether three different clock drawing scores were obtained for each subject. Pearson moment correlation and partial correlation controlling for age and education were used to determine the correlation between variables.
Differences between the three groups were assessed with one-way analysis of variance. The Bonferroni correction was used to adjust P-value for multiple comparisons.
Results Descriptive statistics of the demographic and cognitive characteristics of the patients in the diagnostic groups studied is shown in Table 1. There were no significant between group differences in age, gender and education. The other correlation in these dementia groups became moderate but still very significant.
In this group, Table 1 Descriptive statistics; average S. All correlations described remained significant after controlling for age and education. The clinician may choose one scoring system and not feel obligated to use several simultaneously.
As already mentioned, some studies similarly report high r 0. However, other authors do not unanimously reach these conclusions. Discussion may be similar when correlation between various CDTs is concerned.
We found high correlation between the three CDTs used. In this respect, our findings are similar to Royall et al. Some of the above discrepancies might be explained on methodological grounds: different diagnostic groups, different settings community, in-patients, out-patients, residential homes and different examiners and specialty services.
The correlations are now to be examined in the specific diagnostic groups. These findings are in accordance with the recent suggestion of Richardson and Glass that it may be that particular scoring methods are better suited to assess DAT than multi-infarct dementia and vice-versa.
To conclude, this simple correlations study demonstrates that the practical issue of interchangeability between cognitive tests and CDTs depends on whether the sample is considered in total or according to the specific diagnostic groups. In the different diagnostic groups, some CDTs may be more appropriate than others, perhaps due to some inherent properties e. However, the decreased correlations in the diagnostic groups suggest, that CDTs should be supplemented with other cognitive tests or clinical methods.
The fact that other etiologies for cognitive impairment and normals were not included, undermines the generalizability of our findings.
Acknowledgements The authors acknowledge the assistance of Rena Kurs in preparation of the manuscript. References American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, fourth ed. American Psychiatric Association, Washington D.
Ben-Yehuda, A. The clock-drawing test as a cognitive screening tool for elderly patients in an acute-care hospital. Bourke, J. Brodaty, H. Screening for cognitive impairment in general practice: toward a consensus.
Alzheimer Dis. Burns, A. Assessment Scales in Old Age Psychiatry. Martin Dunitz Ltd. Folstein, M. Mini-Mental State. A practical method for grading the cognitive status of patients for the clinician. Freedman, M. Clock Drawing--A Neuropsychological Analysis. Oxford University Press, New York.
Heinik, J. Types of ambulatory services for the elderly with cognitive and mental disturbances: current status. A preliminary study. Psychiatry Neurol.
Jorm, A. Juby, A. Correlation between the Folstein Mini-Mental State Examination and three methods of clock drawing scoring. Kirby, M. The clock drawing test in primary care: sensitivity in dementia detection and specificity against normal and depressed elderly. Lam, L. Clock-face drawing, reading and setting tests in the screening of dementia in Chinese elderly adults.
Manos, P. The ten point clock test: a quick screen and grading method for cognitive impairment in medical and surgical patients. Psychiatry Med. Mendez, M. Richardson, H. A comparison of scoring protocols on the clock drawing test in relation to ease of use, diagnostic group, and correlations with mini-mental state examination.
Rosen, W. Roth, M. CAMDEX: a standardized instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Royall, D. Not all clock-drawing tests are the same. CLOX: an executive clock drawing task. Clock drawing is sensitive to executive control: a comparison of six methods. Scanlan, J. Comparing clock tests for dementia screening: naive judgments vs. Schramm, U.
Shua-Haim, J. Shulman, K. Clock-drawing: is it the ideal cognitive screening test. The challenge of time: clock-drawing and cognitive function in the elderly. Clock-drawing and dementia in the community: a longitudinal study. Storey, J. A comparison of five clock scoring methods using ROC receiver operating characteristic curve analysis. Tuokko, H.
Terug naar boven INLEIDING Dementie is een globale achteruitgang van het cognitieve functioneren, waarbij ook vaak persoonlijkheidsveranderingen optreden, zodat werk, sociale activiteiten of relaties met anderen verstoord raken. Een dementiesyndroom kan door verschillende ziekten veroorzaakt worden, 1 die ten dele bepalend zijn voor het verloop van het klinische beeld. Meestal vinden de veranderingen zo sluipend plaats dat familieleden het niet beseffen: het dementerende familielid heeft bijvoorbeeld minder interesse in activiteiten en omgeving, is in zichzelf gekeerd, begrijpt complexe situaties, gebeurtenissen en verhalen minder snel of is minder goed in staat beslissingen te nemen. Hun reacties hierop lopen erg uiteen.
Cambridge Cognition Examination (CAMCOG)