Clock drawing test as a feasible tool for identifying behavioral and psychological symptoms of dementia

• Main Authors: Min-fei Chuang, 莊閔妃
• Other Authors: Sin-Chee Chai
• Format: Others
• Language: zh-TW
• Online Access: http://ndltd.ncl.edu.tw/handle/64409977430578924860

碩士 === 慈濟大學 === 神經科學研究所 === 96 === Behavioral and psychological symptoms of dementia (BPSD) describe a heterogeneous range of psychological reaction, psychiatric symptoms and behaviors occurring in people with dementia of any etiology. These symptoms include agitation, aggression, delusion, hallucination, depression, sleep disturbance and wandering. BPSD is quite common and more troubling than amnesic symptoms. The occurrence of BPSD could be precede, concomitant with or after the onset of dementia. Although the prevalence of BPSD increased with disease severity, not any single cognitive screening instrument (Cognitive Abilities Screening Instrument [CASI], Mini-Mental Status Exam [MMSE], et al.) is reported to correlate with BPSD. Clock drawing test (CDT) is a popular screening instrument for cognitive impairments for its quick and easy to administer, non-threatening, and general good inter-rater and test-retest reliability. Performance on CDT correlates moderately to highly with cognitive tests. The study aimed to determine whether impairment of these neuropsychological tests could differentiate demented patient with BPSD from those without BPSD. CASI, MMSE and CDT were conducted in 170 consecutive patients (95 man, 75 woman, mean age 65±13,8, mean years of education 7±4.9) who were screening for cognitive impairments. Neuropsychological measure and CDT were executed by a trained assistant. The demographic data, diagnosis (including Alzheimer’s disease, Parkinson’s disease, vascular dementia, organic brain lesion, mild cognitive impairment and others) and presence of BPSD were obtained by medical record review. The CDT performance using Manos 10-point scoring system was retrospective blinded analyzed by a neurologist. Pearson Chi-Square and contingency coefficients were calculated and indicate excellent correlation between BPSD and poor CDT performance, so as BPSD and low CASI scores. CDT is a useful tool for screening cognitive impairment and BPSD in demented patients.