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Comparison of qualitative and quantitative clock drawing scores among Parkinson's and Alzheimer's disease patients
Abstract
This study addresses part of the theoretical, functional distinction between "cortical" and "subcortical" dementia, namely, whether or not a progressive disease impacting primarily subcortical regions of the brain (Parkinson's disease--PD) will result in relatively greater graphomotor behavioral deficits, while a progressive disease impacting primarily cortical regions (Alzheimer's disease--AD) will result in relatively greater conceptual deficits in cognitive functioning. A clinical instrument which prior research suggests may be useful in identifying these deficits in demented patients, the Clock Drawing Test, was administered according to the method developed by Rouleau et al. (1992). One hundred eleven subjects participated, including elderly controls (NC), AD patients, PD patients with dementia (DPD), and PD patients without dementia (NDPD). Dementia groups were matched for severity of impairment. In two analyses using command, copy, and command-copy change conditions, total scores tended to differentiate the AD group from normal controls consistently but these scores were less consistent for the DPD group. Generally, the DPD group did not differ from the NDPD group, although like the AD group, these scores did tend to differentiate DPD subjects from normal controls. Qualitative error scores for these conditions did not consistently support the predicted relationship, although predicted differences were commonly in the expected direction. To access clinical utility of the Clock Drawing Test, an actuarial analysis of individual scores of dementia was undertaken. Hit rates based on Clock Test scores were above chance but not sufficient in avoiding misses (sensitivity) in diagnosis to warrant the use of this measure alone to assess dementia. However, the Clock Drawing Test appears to be useful when used with other clinical measures that seek convergent validity. Finally, this research does not demonstrate pervasive evidence of a distinction between the functional characteristics of cortical and subcortical dementia. The cortical/subcortical classification, when applied to cognitive and behavioral consequences of progressive diseases of the brain, may not be sufficient to describe the complex relationship between dementias of various etiologies.
Subject Area
Psychotherapy|Psychological tests
Recommended Citation
Daberkow-Stalp, Lisa J, "Comparison of qualitative and quantitative clock drawing scores among Parkinson's and Alzheimer's disease patients" (1996). ETD collection for University of Nebraska-Lincoln. AAI9628229.
https://digitalcommons.unl.edu/dissertations/AAI9628229