A comparison of the clock drawing test and the Pfeiffer short portable mental status questionnaire in a geropsychiatry clinic

Author(s): Varner, R. V., Chen, Y. W., Lesser, J. M.

Journal/Book: Int J Geriat Psychiat. 1997; 12: Baffins Lane, Chichester, W Sussex, England PO19 1UD. John Wiley & Sons Ltd. 526-532.

Abstract: Wolf-Klein and colleagues' clock drawing test (CDT) performance was compared with Pfeiffer's Short Portable Mental Status Questionnaire (Pfeiffer) scores in 145 outpatient geropsychiatry patients. Although normal CDT results were almost always associated with normal Pfeiffer scores, 21% of Pfeiffer normal individuals drew abnormal clocks. Age, but not gender or education, was significantly associated with this finding. Almost all the Pfeiffer normal subjects who drew abnormal clocks were diagnosed with primary psychiatric disorders (85%) or neurologically based organic mood and anxiety disorders (12%); only one (3%) had dementia. We suggest the discrepant performance between the CDT and Pfeiffer may result from psychiatric illness. Contributing to this may be CDT sensitivity to executive skills dysfunction. This dyscontrol can occur in patients with dementia and other neurological disorders, but also presents in some primary mental disorders. Older age may heighten this impairment. In a typical geropsychiatry clinic, the CDT will not have high specificity for Alzheimer's disease as reported by Wolf-Klein and her colleagues. This results from the presence of many patients with primary psychopathology, some of whom will draw abnormal clocks, and a limited number with dementia-particularly Alzheimer's disease. Abnormal CDT results of geropsychiatry outpatients must therefore be interpreted carefully. Additional conclusions regarding the study results are discussed.

Note: Article Gruber NP, Univ Texas, Harris Cty Psychiat Ctr 2D08, 2800 S Macgregor Way, Houston,TX 77021 USA

Keyword(s): Alzheimer's disease; clock drawing; cognition; dementia; executive skills; geriatric psychiatry; mental disorders; neuropsychological tests; ALZHEIMERS-DISEASE; COGNITIVE IMPAIRMENT; BEDSIDE ASSESSMENT; SCREENING-TEST; DEMENTIA; TASK

Zurück | Weiter