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| Original Article | |||||
| Dementia and Neurocognitive Disorders 2009: 8: 1: 53-60 | |||||
| 시계 그리기 검사의 채점방법에 따른 치매 및 경도인지장애 선별에 대한 신뢰도 및 타당도 | |||||
|---|---|---|---|---|---|
| 이강수*,†∙정해관∙오병훈*,†∙홍창형‡∙ 이동우§ | |||||
| 성균관대학교 의과대학 사회의학교실,
연세대학교 의과대학 정신과학교실*, 연세대학교 의학행동과학연구소†, 아주대학교 의과대학 정신과학교실‡, 인제대학교 상계백병원 정신과§ |
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| Reliability and Validity of Four Scoring Methods of Clock Drawing Test for Screening Dementia and Mild Cognitive Impairment | |||||
| Kang Soo Lee, M.D.*,†, Hae-Kwan Cheong, M.D., Ph.D., Byoung Hoon Oh, M.D.*,†, Chang Hyung Hong, M.D.‡, Dong-Woo Lee, M.D.§ | |||||
| Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine,
Suwon; Department of Psychiatry*, Yonsei University College of Medicine, Seoul; Institution of Behavioral Science in Medicine†, Yonsei University College of Medicine, Seoul; Department of Psychiatry‡, Ajou University School of Medicine, Suwon; Department of Neuropsychiatry§, College of Medicine, Inje University, Sanggye Paik Hospital, Seoul, Korea |
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| Background: In order to evaluate the suitability of the clock drawing test (CDT) for a detection of dementia and mild cognitive impairment (MCI), we assessed interrater reliabilities, correlations, and validity of four common scoring methods of the CDT. Methods: The study subjects consisted of 524 community elderly aged between 60 and 85 yr. Clock drawings were scored independently and blindly by three raters according to four different methods (Freedman, Rouleau, Todd, and CERAD-CDT). Subjects were assessed of their cognitive function and activity of daily life. Dementia was assessed by a psychiatrist using DSM-IV or NINCDS-ADRDA criteria. Sensitivity and specificity of the each scoring methods was estimated. By comparing area under the curve, the diagnostic efficiency of the CDT methods for dementia and MCI were evaluated. Results: Inter-rater and intra-rater reliabilities were high for all four scoring methods. The area under the curve was 82.0-89.7% for the dementia and 65.3-66.9% for the mild cognitive impairment. Sensitivity of clock drawing test was between 0.75 and 0.85 for dementia and 0.41 and 0.85 for mild cognitive impairment, and specificity was between 0.80 and 0.84 for dementia and 0.43 and 0.83 for mild cognitive impairment. Conclusions: The reliability and validity of CDT for dementia and MCI in the elderly living in the community was not high. Therefore, CDT is not recommended to be used alone to screen for possible prodromal stages of dementing illnesses and dementia. | |||||
| Key Words: Dementia, Mild cognitive impairment, Clock drawing test, Validity, Reliability, Community | |||||
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