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Background:The aim of the study was to develop the Japanese versions of Executive Interview (J-EXIT25) and Executive Clock Drawing Task (J-CLOX) and to evaluate the aspects of executive function that these two tests will be examining.Methods:The concurrent validity and reliability of J-EXIT25 and J-CLOX were first examined in all participants (n = 201). Next, the relationship between the two tests was examined using receiver operating characteristic (ROC), correlation, and regression analyses in healthy participants (n = 45) and participants with mild cognitive impairment (n = 36) and dementia (n = 95).Results:Satisfactory concurrent validity and reliability of J-EXIT25 and J-CLOX were shown. ROC analysis indicated that J-EXIT25 and J-CLOX1 were superior to the Frontal Assessment Battery, but inferior to the Mini-Mental State Examination (MMSE), in discriminating between non-dementia and dementia. J-EXIT25, J-CLOX1, and J-CLOX2 scores were significantly correlated with age, scores on the MMSE, Instrumental Activities of Daily Living (IADL) and Physical Self-Maintenance Scale (PSMS), and care level. In stepwise regression analyses of IADL scores, MMSE and J-EXIT25 were significantly independent predictors in men, and MMSE, age, and J-CLOX1 were significantly independent predictors in women. J-EXIT25, MMSE, and J-CLOX1 were significantly independent predictors in stepwise regression analysis of PSMS scores, and J-EXIT25 was the only significantly independent predictor in stepwise regression analysis of care level.Conclusions:J-EXIT25 and J-CLOX are valid and reliable instruments for assessment of executive function in older people. The present results suggest that these tests have common and distinct psychometric properties in the assessment of executive function. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to identify the neural correlates of each component of the clock drawing test (CDT) in drug-naïve patients with Alzheimer's disease (AD) using single photon emission computed tomography.Methods: The participants were 95 drug-naïve patients with AD. The Rouleau CDT was used to score the clock drawings. The score for the Rouleau CDT (R total) is separated into three components: the scores for the clock face (R1), the numbers (R2), and the hands (R3). A multiple regression analysis was performed to examine the relationship of each score (i.e. R total, R1, R2, and R3) with regional cerebral blood flow (rCBF). Age, gender, and education were included as covariates. The statistical threshold was set to a family-wise error (FWE)-corrected p value of 0.05 at the voxel level.Results: The R total score was positively correlated with rCBF in the bilateral parietal and posterior temporal lobes and the right middle frontal gyrus. R1 was not significantly positively correlated with rCBF, R2 was significantly positively correlated with rCBF in the right posterior temporal lobe and the left posterior middle temporal lobe, and R3 was significantly positively correlated with rCBF in the bilateral parietal lobes, the right posterior temporal lobe, the right middle frontal gyrus, and the right occipital lobe.Conclusions: Various brain regions were associated with each component of the CDT. These results suggest that an assessment of these components is useful for the detection of localization of brain damage. [ABSTRACT FROM AUTHOR]

Background: There is a strong demand for screening instruments for mild cognitive impairment (MCI), as a pre-stage of dementia. The clock drawing test (CDT) is widely used to screen for dementia, but the utility in screening for MCI remains uncertain. In particular, it is still questionable which scoring system is the best in order to screen for MCI. We therefore aimed to compare the utility of different CDT scoring systems for screening for MCI.Methods: In a sample of 428 subjects of the Leipzig Longitudinal Study of the Aged (LEILA 75+) study, CDT scores of different scoring systems were compared between subjects with and without MCI. Comparison of receiver operating characteristic (ROC; area under the curve, sensitivity, specificity) was performed and inter-rater reliability was calculated.Results: The CDT scores differed significantly between MCI and non-MCI subjects according to all scoring systems applied. However, ROC of the CDT scores was not adequate.Conclusions: None of the present CDT scoring systems has sufficient utility to screen reliably for MCI. The clinical value of the CDT could be improved by using semi-quantitative scoring, having a wider score range and focusing on specific details of the clock (e.g. the hands and numbers). [ABSTRACT FROM AUTHOR]

Background: The clock drawing test (CDT) is a common and widely used cognitive screening instrument for the diagnosis of dementia. However, it has remained unclear whether it is a suitable method to identify mild cognitive impairment (MCI). The aim of this paper is to review systematically the studies concerning the utility of the CDT in diagnosing MCI. Method: A systematic literature search was conducted. All studies dealing with utility of CDT in diagnosing MCI regardless of the applied CDT scoring system and MCI concept were selected. Results: Nine relevant studies were identified. The majority of the studies compared average CDT scores of cognitively healthy and mildly impaired subjects, and four of them identified significant mean differences. If reported, sensitivity and specificity have been mostly unsatisfactory. Conclusion: CDT should not be used for MCI-screening. [ABSTRACT FROM AUTHOR]

Background: Although the Clock Drawing Test (CDT) is the second most used test in the world for the screening of dementia, there is still debate over its sensitivity, specificity, application and interpretation in dementia diagnosis. This study has three main aims: to evaluate the sensitivity and specificity of the CDT in a sample composed of older adults with Alzheimer's disease (AD) and normal controls; to compare CDT accuracy to the that of the Mini-mental State Examination (MMSE) and the Cambridge Cognitive Examination (CAMCOG); and to test whether the association of the MMSE with the CDT leads to higher or comparable accuracy as that reported for the CAMCOG. Methods: Cross-sectional assessment was carried out for 121 AD and 99 elderly controls with heterogeneous educational levels from a geriatric outpatient clinic who completed the Cambridge Examination for Mental Disorder of the Elderly (CAMDEX). The CDT was evaluated according to the Shulman, Mendez and Sunderland scales. Results: The CDT showed high sensitivity and specificity. There were significant correlations between the CDT and the MMSE (0.700-0.730; p<0.001) and between the CDT and the CAMCOG (0.753-0.779; p<0.001). The combination of the CDT with the MMSE improved sensitivity and specificity (SE=89.2- 90%; SP=71.7-79.8%). Subgroup analysis indicated that for elderly people with lower education, sensitivity and specificity were both adequate and high. Conclusions: The CDT is a robust screening test when compared with the MMSE or the CAMCOG, independent of the scale used for its interpretation. The combination with the MMSE improves its performance significantly, becoming equivalent to the CAMCOG. [ABSTRACT FROM AUTHOR]

The article presents a study that examined the reliability of hippocampal volumetry in the early diagnosis of Alzheimer's disease (AD) and the correlation of the severity of hippocampal atrophy with the severity of cognitive decline. A total of 26 patients with Alzheimer's disease, 22 with mild cognitive impairment (MCI) and 15 normal cognitive status (NCS) were selected from Ankara, Turkey. The covariate effects of education, age, gender, hypertension and diabetes were adjusted using a multivariate regression analysis. It was found that hippocampal atrophy was correlated with AD and MCI for right hippocampus. It suggests that a hippocampal volumetry can be used in early diagnosis of cognitive impairment and in grading cognitive decline.

The article presents a study that determined the correlation and agreement between the Mini-mental State Examination (MMSE) and the Clock Drawing Test (CDT) in elderly Brazilian adults with very low levels of formal education. The CDT and MMSE tests taken by a sample of 1118 elderly subjects from Bambui, Brazil were evaluated using Spearman's correlation. Results showed that those scored high with CDT tends to score high in the MMSE while those with low scores in CDT had a wide range of corresponding MMSE scores. It was concluded that the correlation was moderate between MMSE and CDT, and that the CDT may be more practical in developing countries where resources are limited and low education is common in the elderly.

The article reports validates the Clock Reading Test (CRT) which is an instrument for the diagnosis of dementia and disorders of visuo-spatial cognition. CRT evaluates the reliability, validity, sensitivity and specificity of the CRT. CRT is reliable and sensitive for the detection of cognitive impairment in parietal lesions, Alzheimer's disease and Lewy Body dementia.