The clock-drawing test: normative data in adult and elderly Israeli Arabs

Validation of the Greek version of the Abbreviated Mental Test Score: Preliminary findings for cognitively impaired patients of different etiology

BACKGROUND

Screening people's cognitive skills have been proven essential for reference to full assessment. These methods include short scales, such as the Abbreviated Mental Test Score (AMTS). The AMTS is a valid 10-item questionnaire that has been translated into many languages, but not in Greek yet. The aim of this study is the validation of the Greek version of the AMTS with an additional estimation of its cutoff scores.

METHODS

About 132 individuals [60 controls and 72 patients (24 with Parkinson's disease (PD), 24 with Parkinson's disease dementia (PDD), and 24 with Alzheimer's disease (AD)] participated in this study. All participants besides the AMTS completed the Mini Mental State Examination (MMSE), the Tuokko's Clock Drawing Test (CDT), the Instrumental Activities of Daily Living (IADL), the Arizona Battery for Communication Disorders of Dementia (ABCD), the Hellenic versions of the Neuropsychiatric Inventory (NPI), and the Geriatric Depression Scale (GDS-15).

RESULTS

Statistically significant differences were found between all subgroups for the AMTS. The AMTS showed high internal consistency (Cronbach alpha = 0.819 and coefficient omega ω = 0.814). A threshold equal to 6.50 (AUC: 0.908, p = 0.000) between groups with and without cognitive impairment was calculated. The AMTS was significantly correlated with the CDT, IADL, and MMSE.

CONCLUSION

The proposed version of the AMTS can distinguish between groups with and without cognitive impairment. Additionally, the AMTS is found to be clinically valid having high reliability and classification accuracy. Conclusively, it is a valuable instrument for screening different types of cognitively impaired patients.

Clock-drawing test: Normative data of three quantitative scoring methods for Chinese-speaking adults in Shijiazhuang City and clinical utility in patients with acute ischemic stroke

OBJECTIVE

The clock-drawing test (CDT) is a widely used screening tool for detecting cognitive decline. However, normative data for Chinese individuals are scarce. Our study aimed to provide standardized values for the three quantitative CDT scoring methods that were tailored for Chinese-speaking adults in Shijiazhuang City and explore the discriminant validity of the CDT scores in patients with acute ischemic stroke.

METHODS

We conducted the CDT among 418 healthy individuals aged between 35 and 84 years. The CDT was administered and scored by five raters using the method derived from the Montreal Cognitive Assessment (MoCA), Rouleau's, and Babins' scoring systems. The influence of age, education, and sex on the performance in the CDT was analyzed. Furthermore, 336 patients with acute ischemic stroke were enrolled to explore the discriminant validity of CDT scores.

RESULTS

In all three scoring systems, CDT scores were significantly correlated with age and years of education but not with sex. Normative data stratified for age and years of education were established. Interrater and intersystem reliability were high in our study. CDT total scores and subscores showed significant differences between stroke patients and healthy individuals.

CONCLUSIONS

Our study provides CDT normative data using three quantitative scoring methods for Chinese-speaking adults in Shijiazhuang City. Age and education level were the key factors that affected the CDT scores. CDT total scores and subscores provided good discriminant validity for patients with acute ischemic stroke.

Screening for cognitive impairment in Arabic-speaking Hajj pilgrims

Background

Although cognitive impairment is common in the elderly population, studies investigating its rate in Hajj pilgrims are lacking.

Objectives

To estimate the rate of cognitive impairment among a sample of Arabic-speaking elderly Hajj pilgrims and examine its association with their activities of daily living (ADL).

Methods

A cross-sectional study was conducted during the Hajj season 1438 Hijri Calendar (August 2017). Hajj pilgrims were recruited using a probability sampling method and were interviewed for demographics, the MINI-Cog and the ADL instrument.

Results

Among the 340 recruited pilgrims, 99 (29.2%) had positive results in the MINI-Cog indicating probable cognitive impairment. In multivariate logistic regression, the educational level (odds ratio (OD) 0.456; 95% CI 0.346 to 0.598) and the need for help during Hajj (OD 0.581; 95% CI 0.342 to 0.984) were found significantly associated with positive MINI-Cog. Although no significant differences in the ADL were found between pilgrims with and without positive MINI-Cog, the scores of the ADL and the MINI-Cog were found to be positively correlated but weak (rs = 0.134, P = 0.013) indicating a possible association between better cognitive functions and better ADL performance.

Conclusion

Probable cognitive impairment among Arabic elderly Hajj pilgrims was found to be very common. Further diagnostic studies and studies on the impact of cognitive impairment on the performance of Hajj pilgrims are warranted.