• Journal of Oriental Neuropsychiatry
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• v.12 no.2
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• pp.185-191
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• 2001

Objectives: This study aimed to evaluate the usefulness as a screening test of Clock Drawing Test(CDT) compared with the standard K-DRS in probably dementia. Methods: The subjects for this study consisted of 19 elderly persons who visited to the outpatient department of Oriental Neuropsychiatry of the Kyunghee Oriental hospital. They received the K-DRS and the Clock Drawing Test. Three observers evaluated them with circle, numbers, hands. Inter-rater reliability of scores from Clock Drawing Test was assessed and Pearson correlation coefficients were used to examined the relationships between scores from Clock Drawing Test and K-DRS. Results: Correlations between individual raters was highly significant (r= .957, .974, and .970, respectively: p<.001). There was stastically significant correlations between K-DRS and CDT scores (r= 0.849, p<.001). Conclusions: The CDT can be rated reliably by observers and correlations between CDT and K-DRS is significantly high. We confirmed the usefulness of CDT as simple, easily administered, low cost, and reliable general screening test for dementia.

• Korean Journal of Schizophrenia Research
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• v.23 no.1
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• pp.15-28
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• 2020

Objectives: This study investigated the relationship between clock-drawing test (CDT) performance and neuropsychological functions in patients with chronic schizophrenia. Methods: Thirty-one patients with schizophrenia and 30 healthy controls participated in this study. The CDT was administered in three conditions and analyzed using both quantitative and qualitative scoring systems. Comprehensive neuropsychological tests were administered. Results: The results of the quantitative analysis showed that the schizophrenia group performed significantly worse in all three conditions of the CDT compared with the control group. However, no significant differences were observed between the two groups, when the IQ and educational level were controlled. The qualitative analysis showed that the schizophrenia group exhibited significantly more errors in "graphic difficulty" compared with the control group. In addition, CDT quantitative scores were significantly correlated with visuospatial function, memory, attention and executive functions in patients with schizophrenia. Conversely, each qualitative error type was correlated with specific cognitive domains. Furthermore, "graphic difficulty" and "spatial/planning deficit" were identified as predictors of depression symptoms in patients with schizophrenia. Conclusion: The present study demonstrated that the CDT is useful for assessing cognitive dysfunctions in patients with schizophrenia, while qualitative analyses provide more specific information about cognitive deficits compared with quantitative analyses.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.10
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• pp.4612-4618
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• 2012

The purpose of this study was to analyze the reliability and validity of CDT as a screening tool for cognitive impairment for stroke clients living in local community. Two evaluator assessed 51 clients' cognitive function using CDT and K-MMSE from October 2010 to August 2011 year. The researcher analyzed test-retest reliability, interrater reliability, construct validity, construct validity. The test-retest and interrater reliability was higher than .54(p<.01). The construct validity and concurrent validity was statistically significant(p<.01). So, The CDT using productive method and scoring system of Freedman et al., may be applied to screen cognitive impairment of clients with stroke.

• Dementia and Neurocognitive Disorders
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• v.17 no.3
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• pp.100-109
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• 2018

Background and Purpose: Although the clock drawing test (CDT) is a widely used cognitive screening instrument, there have been inconsistent findings regarding its utility with various scoring systems in patients with mild cognitive impairment (MCI) or dementia. The present study aimed to identify whether patients with MCI or dementia exhibited impairment on the CDT using three different scoring systems, and to determine which scoring system is more useful for detecting MCI and mild dementia. Methods: Patients with amnestic mild cognitive impairment (aMCI), vascular mild cognitive impairment (VaMCI), mild Alzheimer's disease (AD), mild vascular dementia (VaD), and cognitively normal older adults (CN) were included. All participants were administered the CDT, the Korean-Mini Mental State Examination (K-MMSE), and the Clinical Dementia Rating scale. The CDT was scored using the 3-, 5-, and 15-point scoring systems. Results: On all three scoring systems, all patient groups demonstrated significantly lower scores than the CN. However, while there were no significant differences among patients with aMCI, VaMCI, and AD, those with VaD exhibited the lowest scores. Area under the Receiver Operating Characteristic curves revealed that the three CDT scoring systems were comparable with the K-MMSE in differentiating aMCI, VaMCI, and VaD from CN. In differentiating AD from CN, however, the CDT using the 15-point scoring system demonstrated the most comparable discriminability with K-MMSE. Conclusions: The results demonstrated that the CDT is a useful cognitive screening tool that is comparable with the Mini-Mental State Examination, and that simple CDT scoring systems are sufficient for differentiating patients with MCI and mild dementia from CN.

• 한국노년학
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• v.40 no.2
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• pp.325-340
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• 2020

Early diagnosis and intervention of dementia is critical to minimize future risk and cost for patients and their families. The purpose of this study was to develop and validate Figure-Copy Test(FCT), as a new dementia screening test, that can measure neurological damage and cognitive impairment, and then to examine whether the grading precesses for screening can be automated through machine learning procedure by using FCT imag es. For this end, FCT, Korean version of MMSE for Dementia Screening (MMSE-DS) and Clock Drawing Test were administrated to a total of 270 participants from normal and damaged elderly groups. Results demonstrated that FCT scores showed high internal constancy and significant correlation coefficients with the other two test scores. Discriminant analyses showed that the accuracy of classification for the normal and damag ed g roups using FCT were 90.8% and 77.1%, respectively, and these were relatively higher than the other two tests. Importantly, we identified that the participants whose MMSE-DS scores were higher than the cutoff but showed lower scores in FCT were successfully screened out through clinical diagnosis. Finally, machine learning using the FCT image data showed an accuracy of 73.70%. In conclusion, our results suggest that FCT, a newly developed drawing test, can be easily implemented for efficient dementia screening.

• Sleep Medicine and Psychophysiology
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• v.27 no.1
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• pp.16-23
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• 2020

Objectives: Sleep disturbance in the elderly is associated with cognitive decline. Sleep quality is known to deteriorate with age, and prospective studies seldom have examined the relationship between sleep quality and cognitive function. This study investigates the relationship between early sleep quality and cognitive function based on six-year follow-up data of community individuals older than 60 years. Methods: The participants included 622 community elderly people older than 60 years from Jinju-Si. The final analysis comprised 322 elderly people. Pittsburgh sleep quality index (PSQI) and the Korean version of Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) were used to assess early sleep quality and cognitive function after six years. Multiple linear regression analysis was performed to investigate the association between early sleep quality and cognitive function in the elderly. Results: Early sleep quality (PSQI) was significantly associated with the results of the digit span test, clock drawing test (clox 1), and word recall test after six years. Sleep quality (PSQI) decreased significantly after six years, and lower quality of sleep (PSQI) score was associated with higher digit span test score (β = -0.167, p = 0.026) and higher clock drawing test score (β = -0.157, p = 0.031). Lower quality of sleep (PSQI) score was associated with higher word recall test (β = -0.140, p = 0.039). Conclusion: The digit span test, word recall test, and clock drawing task (CLOX 1) shown to be significantly associated to sleep quality can be performed fast and easily in clinical practice. It is important to assess early cognitive function in the elderly with poor sleep quality, and further studies could suggest that these tests may be useful screening tests for early dementia in elderly with poor sleep quality.

• The Journal of Internal Korean Medicine
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• v.44 no.2
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• pp.87-96
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• 2023

Objective: This study reports the effectiveness of the Korean medicine treatment of patients with intracerebral and intraventricular hemorrhages suffering unilateral neglect symptoms. Case presentation: The patient was treated using Korean medicine, including acupuncture, herbal medicine, moxibustion, and a limb activation exercise. We measured Unilateral Neglect Symptom progress with a numeric rating scale, Albert's test, Line bisection test, Clock drawing test, and Catherine Bergego Scale. After eight days of combined Korean medicine and rehabilitation exercise, the Unilateral Neglect Symptom intensity reduced from NRS 8 to 6. In addition, Albert's test score decreased from 2.5% to 0%. The Line bisection test score decreased from 19 mm to 12 mm, and the Clock drawing test score improved from 8 to 10. Last, the Catherine Bergego Scale decreased from 12 to 9. No adverse events were observed during treatment. Conclusion: This study suggested that a complex treatment including Jaeumkunbi-tang, acupuncture, moxibustion, and limb activation exercise can be effective for an intracerebral hemorrhage with intraventricular hemorrhage patient suffering from Unilateral Neglect Symptoms. Consequently, more research is needed in the future.

• The Journal of the Korea Contents Association
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• v.13 no.5
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• pp.322-331
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• 2013

The aim of this study was to investigate the effects of occupational therapy with physical exercise on executive function with dementia. For eight elderly persons with mild or moderate dementia, we executed physical exercise with group activity for 10 weeks from April to June, 2012, one times per week, and 50 minutes each time. Before and after the physical activities, the old adults were tested with Verbal Fluency Test(VFT), Trail Making Test A/B(TMT A/B), Clock Drawing Test(CDT). After the physical exercise, the subjects showed significant changes in the score of CDT(p<0.1). In contrast, there was no significant effect in VFT, TMT A. The results of this study show that occupational therapy with physical exercise program for demented elderly people is a useful therapeutic approach by enhancing the their quality of life through improving and maintaining their executive function.

• Korean Journal of Biological Psychiatry
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• v.14 no.3
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• pp.184-193
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• 2007

Objectives:There is increasing evidence that the cerebellum plays an important role in cognition and psychiatric symptoms as well as motor coordination. The concept of cognitive dysmetria has been making cerebellar function in schizophrenia the focus of current studies. In other words, disruption in the corticocerebellum-thalamic -cortical circuit could lead to disordered cognition and clinical symptoms of schizophrenia. The purposes of this study were to determine cerebellar dysfunction in male schizophrenic patients semiquantitatively with ICARS and to investigate the clinical and cognitive correlates of ICARS in patients. Methods:We compared the scores of cerebellar neurologic sign using ICARS in 47 male patients with a DSM-IV-TR diagnosis of schizophrenia with 30 gender and age-matched healthy control subjects. The semiquantitative 100-point ICARS consists of 19 items divided into 4 unequally weighted subscores:posture and gait disturbances, kinetic functions, speech disorders and oculomotor disorders. All subjects were also assessed with cognitive function test. Cognitive functions were evaluated by Korean-Mini Mental Status Examination (K-MMSE), Verbal fluency test, and Clock drawing test. The patients were administered Korea version of Positive and Negative Symptom Scale(K-PANSS) to assess the symptom severity. Results:Schizophrenic patients had significantly higher scores on the ICARS than control subjects with posture and gait disturbances, kinetic functions, and oculomotor disorders. They also showed more significant impairments in cognitive function tests than control subjects. There was a significant correlation between ICARS and negative symptoms of patients. In cognitive function test, Clock drawing test was significantly associated with negative symptoms. In addition, Clock drawing test was negatively correlated with the total score of ICARS. Conclusion:In this study, we confirmed that schizophrenic patients have significant impairments in cognitive and cerebellar function, and that those were related with negative symptoms of schizophrenic patients. These results support a role of the cerebellum in schizophrenia. It is meaningful that we used a structured, and reliable procedure for rating neurological soft signs, ICARS. We hope that future prospective studies using a similar design help that rate of neurological sign should have been visible with the progression of illness.

• The Korean Journal of Rehabilitation Nursing
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• v.11 no.2
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• pp.90-98
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• 2008

Purpose: The purpose of this study was to examine the cognitive function and degree of dementia patient by doing clock drawing test and to explore the relationship among other dementia screening test. Method: The study subjects were 94 dementia in patients department. The data was collected by face to face interview by clinical psychologist from January 2007 to February 2008. The tools were Clock Drawing Test, K-MMSE, K-3MS and CDR Scale. Results: 1) The average score of CDT was 5.13 (2.54), of K-MMSE was 20.53 (4.85), of K-3MS was 61.66 (16.46), and of CDR was 1.2 (.72), those scores showed dementia. 2) There was a statistically the significant difference in CDT (F=2.83, p=.043) and CDR (F=2.00, p=.008) by age. CDT has shown the differences by gender (t=-2.42, p=.018) and education (F=7.66, p=.000). 3) There were significant relationships between CDT and K-MMSE (r=-.294. p=.004), K-3MS (r=-.335, p=.001), and CDR (r=.286, p=.008). Conclusion: It is believed that using CDT which measures the visuospatial ability of dementia patients and K-MMSE which assesses an ability of language and orientation and K-3MS at the same time helps examining the beginning and the progressive degree of dementia more easily and objectively.