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Amaç: Saat çizme testi (SÇT) kognitif fonksiyonları değerlendirmede kullanılan kısa, pratik ve güvenli bir testtir. Biz SÇT ile 25-hidroksivitamin D seviyesinin güneşe maruziyet ve yürüme süresi için prediktif olup olmadığını ve SÇT’nin düşük eğitim düzeyli (DE) yaşlılarda güvenilir olup olmadığını araştırmayı amaçladık.Materyal ve Metod: İç hastalıkları kliniğine başvuran 65 yaş üzeri demansı olmayan 185 DE hasta bu çalışmaya dahil edildi. Hastaların demografik verileri, güneş maruziyetleri, yürüme süreleri, koroner kalp hastalığı (KKH) öyküsü ve düşme sayısı kaydedildi. SÇT, Manos skorlama sistemi kullanılarak ölçüldü. Bulgular: Çalışma populasyonu yaş ortalaması 73 ± 6 yıl olan 127 (%68.6) erkek ve yaş ortalaması 70 ± 5 yıl olan 58 (%31.4) kadın hastayı içeriyordu. Manos skorlama sistemine göre, 90 (%48.6) kişinin CDT skoru 0, 70 (%37.9) kişinin CDT skoru 1-9 arası ve 25 (%13.5) kişinin CDT skoru 10 idi. Hastaların ortalama D vitamin düzeyi 18.4 ± 7.3 ng/mL idi. D vitamin seviyesi ve SÇT skorları güneş maruziyeti, yürüme süresi ve düşme sayısı ve KKH için tahmin edici değerdeydi.Sonuç: DE kişilerin SÇT skorları bilinç fonksiyonlarını göstermede güvenilir değildir. Bu çalışma gösterdi ki DE bireylerde D vitamin seviyeleri güneş maruziyeti, yürüme süresi, düşme sayısı ve KKH sıklığını göstermede SÇT skorundan daha güçlüdür.

Purpose: We aimed to investigate whether CDT and 25-hydroxyvitamin D (25OHD) level are predictors for sun exposure and walking duration, and aimed to investigate whether CDT is reliable in low educated (LE) elderly. Material and Methods: A total of 185 LE patients without dementia above the age of 65 who had applied to internal medicine clinic were included in the study. The patients' demographic data, sun exposure, walking duration, a history of coronary artery disease (CAD) and the number of falls were recorded. Clock drawing was measured using Manos scoring system. Results: The study population included 127 (68.6%) males with a mean age of 73 +/- 6 years and 58 (31.4%) females with a mean age of 70 +/- 5 years. According to Manos scoring system a total of 90 (48.6%) subjects had a CDT score of 0, 70 (37.9%) subjects had a CDT score of 1-9 and 25 (13.5%) subjects had a CDT score of 10. The mean vitamin D level of the patients was 18.4 +/- 7.3 ng/mL. Vitamin D levels and CDT scores were predictive for sun exposure, duration of walking, number of falls and CAD. Conclusion: CDT scores of LE subjects were unreliable to demonstrate cognitive functions. This study has shown that vitamin D levels to be more potent predictor than CDT scores to demonstrate sun exposure, walking duration, numbers of falls and the incidence of CAD in LE subjects. [Cukurova Med J 2015; 40(1.000): 6-17]

Objective: The clock drawing test (CDT) version with the pre-drawn circle has been widely used in research and clinical practice without standardized Turkish norms. The present study aimed to standardize CDT scores according to the most frequently used scoring methods in the literature (Manos-Wu and Shulman) and to estimate the validity and reliability of both methods. Materials and Methods: The norm determination phase of the study was performed with 244 healthy individuals in the age range of 50-92 years. The effects of age, education, and sex on the CDT scores were examined and normative data stratified by age and education were derived. Test-retest reliability, inter-rater reliability, and concurrent validity and criterion validity of the two scoring methods were tested. Criterion validity was assessed using the ROC analysis to examine the extent to which the CDT scores could distinguish among healthy individuals, patients with mild cognitive impairment (MCI), and patients with Alzheimer's disease (AD). Results: In the Manos-Wu method, age and education had significant effects on CDT scores of healthy individuals; however, in the Shulman method, only an education effect was found. Both methods had high test-retest reliability (Manos-Wu, 0.81; Shulman, 0.72) and inter-rater reliability (Manos-Wu, 0.98; Shulman, 0.96) and showed high correlations with each other and with other cognitive screening tests. The area under the ROC curve had high values only in discriminating between healthy individuals and AD, and healthy individuals and MCI. Conclusion: In the present study, detailed normative data for individuals aged 50 and older were established. Age and education levels should be taken into account when interpreting CDT scores. Both scoring methods provided similar results in terms of high test-retest and inter-rater reliability, as well as high concurrent and criterion validity. [ABSTRACT FROM AUTHOR]

Objective: Clock Drawing Test (CDT) has been widely used in dementia screening as a practical and valid tool assessing various neuropsychological domains. Many scoring systems requiring different instructions and methodologies were proposed for CDT and there are several studies comparing the diagnostic accuracy of these methods. However, there is still no clear agreement on which one is the best for clinical and research settings. The present study aimed to investigate the psychometric properties of the Turkish versions of the three most commonly used CDTs (Shulman's, Sunderland's and Watson's CDTs) and to compare their diagnostic accuracy with each other and Mini Mental State Examination (MMSE). Methods: The study sample consisted of elderly patients with dementia (n=65) and healthy controls (n=112) who were admitted to the Department of Geriatric Psychiatry and Geriatrics of a University hospital. The subjects were administered MMSE and CDT. In CDTs, the subjects were asked to place the numbers and the hands of a clock in a pre-drawn circle showing the time setting for the clock as "10 after 11". CDTs were scored according to three different CDT scoring methods (Shulman, Sunderland and Watson) by two blinded raters. Discriminant and concurrent validity and interrater reliability were assessed. Receiver operating characteristic (ROC) analysis was also performed to calculate cut-off scores and sensitivity/specificity values. Areas under the curve (AUCs) of CDTs were compared. Results: The mean scores of all CDTs were significantly different in dementia patients compared to the controls. CDT scores were significantly correlated with MMSE scores. All CDTs had high sensitivity values, while Watson's CDT had lower specificity. AUC value for MMSE was higher than that for CDTs and AUC value for Watson's CDT was lower than the values for the other two CDTs. When Shulman/Sunderland CDTs were used together with MMSE, the sensitivity increased up to 100%. Conclusion: The Turkish versions of all three CDTs can be used in dementia screening. Shulman's or Sunderland's CDT may be preferred to Watson's CDT, since they have higher specificity and diagnostic accuracy. [ABSTRACT FROM AUTHOR]