CLOX: an executive clock drawing task

被引:619
作者
Royall, DR
Cordes, JA
Polk, M
机构
[1] Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78284 USA
[2] S Texas Vet Hlth Syst, Audie L Murphy Div, Geriatr Res Educ Clin Ctr, Dept Med, San Antonio, TX USA
[3] Univ Texas, Hlth Sci Ctr, Div Clin Pharmacol, San Antonio, TX 78284 USA
关键词
dementia; Alzheimer's; executive; assessment;
D O I
10.1136/jnnp.64.5.588
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective-To describe a clock drawing task (CLOX) designed to elicit executive impairment and discriminate it from non-executive constructional failure. Subjects-90 elderly subjects were studied (45 elderly and well persons from the independent living apartments of a continuing care retirement community and 45 patients with probable Alzheimer's disease). The clock drawing performance of elderly patients was compared with that of 62 young adult controls. Methods-Subjects received the CLOX, an executive test (EXIT25), and the mini mental state examination (MMSE). The CLOX is divided into an unprompted task that is sensitive to executive control (CLOX1) and a copied version that is not (CLOX2). Between rater reliability (27 subjects) was high for both subtests. Results-In elderly subjects, CLOX subscores correlated strongly with cognitive severity (CLOX1: r=-0.83 v the EXIT25; CLOX2: r=0.85 v the MMSE). EXIT25 and MMSE scores predicted CLOX1 scores independently of age or education (F(4,82)=50.7, p<0.001; R-2=0.71). The EXIT25 accounted for 68% of CLOX1 variance. Only the MMSE significantly contributed to CLOX2 scores (F(4,72)=57.2, p<0.001; R-2=0.74). CLOX subscales discriminated between patients with Alzheimer's disease and elderly controls (83.1% of cases correctly classified; Wilkes' lambda=0.48, p<0.001), and between Alzheimer's disease subgroups with and without constructional impairment (91.9% of cases correctly classified; Wilkes' lambda=0.31, p<0.001). Conclusions-The CLOX is an internally consistent measure that is easy to administer and displays good inter-rater reliability. It is strongly associated with cognitive test scores. The pattern of CLOX failures may discriminate clinical dementia subgroups.
引用
收藏
页码:588 / 594
页数:7
相关论文
共 45 条
[1]   EFFECT OF EDUCATION ON THE CLOCK-DRAWING DEMENTIA SCREEN IN NONDEMENTED ELDERLY PERSONS [J].
AINSLIE, NK ;
MURDEN, RA .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1993, 41 (03) :249-252
[2]  
AXELROD BN, 1992, J CLIN PSYCHOL, V48, P68, DOI 10.1002/1097-4679(199201)48:1<68::AID-JCLP2270480110>3.0.CO
[3]  
2-N
[4]   PERFORMANCE ON FRONTAL-LOBE TESTS IN HEALTHY, OLDER INDIVIDUALS [J].
BOONE, KB ;
MILLER, BL ;
LESSER, IM ;
HILL, E ;
DELIA, L .
DEVELOPMENTAL NEUROPSYCHOLOGY, 1990, 6 (03) :215-223
[5]  
BRAAK H, 1994, NEURODEGENERATIVE DI
[6]   LATERAL ASYMMETRIES IN PRIMARY DEGENERATIVE DEMENTIA OF THE ALZHEIMER TYPE - A CORRELATIVE STUDY OF COGNITIVE, HEMODYNAMIC AND EEG DATA, IN RELATION WITH SEVERITY, AGE OF ONSET AND SEX [J].
CELSIS, P ;
AGNIEL, A ;
PUEL, M ;
LETINNIER, A ;
VIALLARD, G ;
DEMONET, JF ;
RASCOL, A ;
MARCVERGNES, JP .
CORTEX, 1990, 26 (04) :585-596
[7]   QUANTITATIVE CEREBRAL ANATOMY OF THE AGING HUMAN BRAIN - A CROSS-SECTIONAL STUDY USING MAGNETIC-RESONANCE-IMAGING [J].
COFFEY, CE ;
WILKINSON, WE ;
PARASHOS, IA ;
SOADY, SAR ;
SULLIVAN, RJ ;
PATTERSON, LJ ;
FIGIEL, GS ;
WEBB, MC ;
SPRITZER, CE ;
DJANG, WT .
NEUROLOGY, 1992, 42 (03) :527-536
[8]   MINI-MENTAL STATE - PRACTICAL METHOD FOR GRADING COGNITIVE STATE OF PATIENTS FOR CLINICIAN [J].
FOLSTEIN, MF ;
FOLSTEIN, SE ;
MCHUGH, PR .
JOURNAL OF PSYCHIATRIC RESEARCH, 1975, 12 (03) :189-198
[9]  
Freedman M., 1994, Clock Drawing: A Neuropsychological Analysis
[10]  
GAVIRIA FM, 1996, 129 ANN M AM PSYCH A