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The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease

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Longitudinal changes in clock drawing test (CDT) performance according to dementia subtypes and severity.

Ji Hee Lee¹, Eung Seok Oh, Seong Hae Jeong

¹Departments of Neurology, Chungnam National University, College of Medicine, Hospital Department of Neurology, 640 Daesadong, Jung-gu, Daejon 301-721, South Korea.

Archives of Gerontology and Geriatrics

|November 2, 2010

Summary

The Clock Drawing Test (CDT) shows distinct error patterns in dementia subtypes and severity. Spatial and planning deficits (SPD) are common in mild to moderate dementia, while conceptual deficits (CD) dominate severe dementia.

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Area of Science:

Neuroscience
Gerontology
Cognitive Psychology

Background:

The Clock Drawing Test (CDT) is a widely used screening tool for dementia.
Understanding longitudinal changes in CDT performance and error types across dementia subtypes and severity is crucial.

Purpose of the Study:

To investigate longitudinal changes in CDT performance and error types in patients with Alzheimer's disease (AD), Parkinson's disease with dementia (PDD), and Vascular Dementia (VaD).
To analyze how CDT error patterns differ based on dementia severity.

Main Methods:

235 dementia patients (AD, PDD, VaD) were assessed every 6 months using the Korean version of the mini-mental state examination (MMSE-K) and CDT.
CDT errors were classified into stimulus-bound response (SBR), conceptual deficit (CD), spatial and/or planning deficit (SPD), and perseveration error (PE).
Patients were grouped by initial MMSE-K scores into severe, moderate, and mild cognitive impairment.

Main Results:

Longitudinal CDT and MMSE-K scores did not significantly differ between dementia subtypes.
Spatial and/or planning deficit (SPD) was the most common error in mild to moderate dementia.
Conceptual deficit (CD) was the most frequent error in severe dementia, and also in AD patients after 18 months.

Conclusions:

Longitudinal CDT error analysis can reveal distinct cognitive deterioration patterns across dementia subtypes and stages.
CDT error profiling offers valuable insights into the progression of cognitive decline in different dementia populations.