Detecting cognitive impairment in individuals at risk for cardiovascular disease: the "Clock-in-the-Box" screening test

作者：Grande Laura J; Rudolph James L^*; Milberg William P; Barber Colleen E; McGlinchey Regina E

来源：International Journal of Geriatric Psychiatry, 2011, 26(9): 969-975.

DOI：10.1002/gps.2635

• clock drawing
• cognitive screening
• cardiovascular
• executive function
• memory

Objective: The purpose of this study was to evaluate the performance on the Clock-in-the-Box (CIB), a screening measure for cognitive function, relative to neuropsychological testing in an older population with cardiovascular risk.
Methods: A prospective cohort of older patients (>50 years) with cardiovascular risk was recruited to perform the CIB and complete a brief neuropsychological battery consisting of Trailmaking tests, the Hopkins Verbal Learning Test (HVLT), and fluency tasks. Performance on the CIB was scored according to standard criteria (range 0-8, 0-worst). The performance on the total CIB, working memory subscale (CIB-WM), and planning/organization (COB-PO) was compared to neuropsychological measures.
Results: The cohort (n = 127) was older (age 67 +/- 7 years) and diverse with 33% female (n = 42) and 42% non-white race (n = 53). Cardiac risk factors were prevalent: hypertension (83%), hyperlipidemia (74%), overweight (84%), diabetes (48%), prior cardiac disease (39%), and smoking (11%). The CIB (mean 6.5 +/- 1.3) took 84 +/- 21 s on average to complete and had good inter-rater reliability (kappa = 0.809, p < 0.01). The CIB-WM subscale was significantly correlated with performance on Trailmaking B and HVLT learning, recall, and recognition. The CIB-PO subscale was significantly associated with semantic and phonemic fluency, Trailmaking B, and HVLT learning and recall. In regression modeling, CIB-WM significantly predicted performance on HVLT learning, recall, and retention. CIB-PO subscale predicted performance on Trailmaking B, HVLT learning, and HVLT recall.
Conclusions: The CIB is a brief cognitive screening instrument with good reliability and predictive validity in a CV risk population. The CIB-WM and CIB-PO subscales could provide utility for clinicians. Published in 2010 by John Wiley & Sons, Ltd.

• 出版日期2011-9