Function of Three-point Scoring System for the Clock Drawing Test in Differentiating between Alzheimer’s Disease and Vascular dementia in China_West China Medical Journal

Authors：

LANG Qi ¹ , YANG Xue ¹ , FENG Hong ² , CHEN Ning ¹ ,  HE Li ¹

1. Department of Neurology, West China Hospital; 2. West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

HE Li, Email: lunch_0518@163.com

Keywords：

阿爾茨海默病; 血管性癡呆; 畫鐘測驗

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【摘要】　目的　探討3分法畫鐘測驗（clock drawing test，CDT）對阿爾茨海默病患者（Alzheimer disease，AD）與血管性癡呆患者（vascular dementia，VD）的鑒別作用。　方法　收集四川大學華西醫院神經內科門診及住院部2009年9月-2010年6月就診的認知功能障礙患者150例，進行病史采集及神經心理測試量表，篩選出AD患者57例及VD患者43例，共計納入100例。在兩者間進行CDT，分析兩者間CDT有無差別、CDT與中文版簡易智能量表（Chinese version of the mini-mental state examination，MMSE）及臨床癡呆評定量表（clinical dementia rating scale，CDR）的相關性。　結果　 AD患者及VD患者間CDT差異無統計學意義（P gt;0.05）；CDT與MMSE及CDR有相關性，Spearman相關系數分別為0.573和-0.542（P lt;0.001）。　結論　 3分法畫鐘測驗無法準確區分AD和VD，但對粗略判斷AD及VD程度可能有一定效果。
【Abstract】　Objective　 To investigate the differential function of the three-point scoring system for the clock drawing test (CDT) between Alzheimer’s disease (AD) and vascular dementia (VD). 　Methods　 We analyzed the clinical data of 150 patients with cognitive impairment treated in the neurology and inpatient departments of our hospital from September 2009 to July 2010. Medical history of the subjects were collected. Through the assessment by neurological and psychological rating scale, we picked out 57 patients with AD and 43 with VD and tested them with CDT. The difference of CDT results between the two groups, and the correlation of CDT with Chinese version of the mini-mental state examination (MMSE) and clinical dementia rating scale (CDR) were analyzed.　Results　 There was no statistical difference of CDT results between AD and VD patients (P gt;0.005). CDT had a correlations with MMSE and CDR, the Spearman correlation coefficient being 0.573 and -0.542 respectively (P lt;0.001).　Conclusion　 The three-point scoring system for the clock drawing test cannot differentiate exactly between Alzheimer Disease and Vascular Dementia, but it can make a gross judgment of the degree of AD and VD.

Citation： LANG Qi,YANG Xue,FENG Hong,CHEN Ning,HE Li. Function of Three-point Scoring System for the Clock Drawing Test in Differentiating between Alzheimer’s Disease and Vascular dementia in China. West China Medical Journal, 2011, 26(4): 500-502. doi: Copy

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2.	Malone DC, McLaughlin TP, Wahl PM, et al. Burden of Alzheimer’s disease and association with negative health outcomes[J]. Am J Manag Care, 2009, 15(8): 481-488.
3.	孟超, 張新卿, 周景升, 等. 畫鐘測驗鑒別阿爾茨海默病和血管性癡呆[J]. 中國臨床康復, 2004, 8(31): 6856-6858.
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7.	Hachinski VC, Lanssen NA, Marshall J. Multi-infarct dementia: a cause of mental deterioration in the elderly[J]. Lancet. 1974, 2(7874): 207-210.
8.	Morris JC. The Clinical Dementia Rating (CDR): current version and scoring rules[J]. Neurology. 1993, 43(11): 2412-2414.
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11.	Shulman KI. Clockdrawing: is it the ideal cognitive screening test?[J]. Int J Geriatr Psychiatry, 2000, 15(6): 548-561.
12.	Royall DR, Cordes JA, Polk M. CLOX: an executive clock drawing task[J]. J Neurol Neurosurg Psychiatry, 1998, 64(5): 588-594.
13.	Heink J, Solomesh I, Raikher B, et al. Can clock drawing test help to differentiate between dementia of the Alzheimer’s type and vascular dementia? A preliminary study[J]. Int J Geriatr Psychiatry, 2002, 17(8): 699-703.
14.	譚紀萍, 王魯寧, 張曉紅, 等. 阿爾茨海默病與血管性癡呆患者血管因素的差異比較[J]. 中國臨床康復, 2004, 8(1): 85-87.
15.	孟超, 張新卿. 畫鐘測驗檢測認知功能損害[J]. 中國神經精神疾病雜志, 2004, 30(6): 452-454.
16.	劉桂芳, 馮亞青, 劉衛剛. 認知功能篩查量表對阿爾茨海默病的診斷意義[J]. 中華老年心腦血管病雜志, 2007, 9(5): 301-303.
17.	周愛紅, 賈建平. 畫鐘測驗對輕度血管性認知障礙和血管性癡呆的診斷作用[J]. 中國神經精神疾病雜志, 2008, 34(2):72-75.

1. 　Herrera E Jr, Caramelli P, Silveira AS, et al. Epidemiologic survey of dementia in a community-dwelling Brazilian population[J]. Alzheimer Dis Assoc Disord, 2002, 16(2): 103-108.
2. 　Malone DC, McLaughlin TP, Wahl PM, et al. Burden of Alzheimer’s disease and association with negative health outcomes[J]. Am J Manag Care, 2009, 15(8): 481-488.
3. 　孟超, 張新卿, 周景升, 等. 畫鐘測驗鑒別阿爾茨海默病和血管性癡呆[J]. 中國臨床康復, 2004, 8(31): 6856-6858.
4. 　Gorelick PB. Risk factors for vascular dementia and alzheimer disease[J]. Stroke, 2004, 35(Supple 1): 2620-2622.
5. 　American psychiatric association committee and statistics. Diagnostic and statistical manual of mental disorders[M]. 4th ed. Washington: American Psychiatric Association, 1994: 143-147.
6. 　Brucki SMD, Nitrini R, Caramelli P, et al. Suggestions for utilization of the mini-mental state examination in Brazil[J]. Arq Neuropsiquiatr, 2003, 61(3B): 771-781.
7. 　Hachinski VC, Lanssen NA, Marshall J. Multi-infarct dementia: a cause of mental deterioration in the elderly[J]. Lancet. 1974, 2(7874): 207-210.
8. 　Morris JC. The Clinical Dementia Rating (CDR): current version and scoring rules[J]. Neurology. 1993, 43(11): 2412-2414.
9. 　黃明生, 李進, 況偉宏. 阿爾茨海默病與血管性癡呆的關系和鑒別[J]. 中華全科醫師雜志, 2006, 5(6): 331-333.
10. 　王新德, 湯慈美. 神經病學(第7卷): 神經心理學[M]. 北京: 人民軍醫出版社, 2001: 292-295.
11. 　Shulman KI. Clockdrawing: is it the ideal cognitive screening test?[J]. Int J Geriatr Psychiatry, 2000, 15(6): 548-561.
12. 　Royall DR, Cordes JA, Polk M. CLOX: an executive clock drawing task[J]. J Neurol Neurosurg Psychiatry, 1998, 64(5): 588-594.
13. 　Heink J, Solomesh I, Raikher B, et al. Can clock drawing test help to differentiate between dementia of the Alzheimer’s type and vascular dementia? A preliminary study[J]. Int J Geriatr Psychiatry, 2002, 17(8): 699-703.
14. 　譚紀萍, 王魯寧, 張曉紅, 等. 阿爾茨海默病與血管性癡呆患者血管因素的差異比較[J]. 中國臨床康復, 2004, 8(1): 85-87.
15. 　孟超, 張新卿. 畫鐘測驗檢測認知功能損害[J]. 中國神經精神疾病雜志, 2004, 30(6): 452-454.
16. 　劉桂芳, 馮亞青, 劉衛剛. 認知功能篩查量表對阿爾茨海默病的診斷意義[J]. 中華老年心腦血管病雜志, 2007, 9(5): 301-303.
17. 　周愛紅, 賈建平. 畫鐘測驗對輕度血管性認知障礙和血管性癡呆的診斷作用[J]. 中國神經精神疾病雜志, 2008, 34(2):72-75.

West China Medical Journal

Function of Three-point Scoring System for the Clock Drawing Test in Differentiating between Alzheimer’s Disease and Vascular dementia in China

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