Abstract：
The present study aims to be the first to validate the Tuokko version of the Clock Drawing Test (CDT) and estimate its cutoff score after its translation into the Greek language and administration in the Greek population.
One hundred and thirty-two individuals participated in this study [60 with Good Cognitive Health (GCH), 24 with Parkinson\'s Disease (PD), 24 with Parkinson\'s Disease Dementia (PDD) and 24 with Alzheimer\'s Disease (AD)]. The CDT was administered to all participants. Additionally, the cognitive and mental status of the sample were estimated through the use of the Mini Mental State Examination (MMSE), Abbreviated Mental Test Score (AMTS), Arizona Battery for Communication Disorders of Dementia (ABCD), Instrumental Activities of Daily Living (IADL), the Neuropsychiatric Inventory (H-NPI) and the Geriatric Depression Scale -15 (GDS-15).
Statistically significant differences were found between all groups on the CDT, with AD patients having lower scores than all subgroups in the study. The CDT showed a high internal consistency (Cronbach\'s alpha = 0.832). The ROC analysis provided a cutoff point equal to 4.00 (AUC: 0.821, p < 0.001) between the Cognitively Unimpaired Group (CUG: GCH and PD group) and the Cognitively Impaired Group (CIG: PPD and AD patients), 5.00 (AUC: 0.845, p < 0.001) between the GCH group and the PDD group, and 4.00 (AUC: 0.780, p < 0.001) between the GCH group and the AD group. Finally, the cutoff point between the PD group and the PDD group was 4.00 (AUC: 0.896, p < 0.005), and 3.00 (AUC: 0.899, p < 0.001) between the PD group and the AD group. Significant positive Pearson\'s correlations were observed between CDT and MMSE (r = 0.808, p < 0.001), CDT and AMTS (r = 0.688, p < 0.001), CDT and ABCD (r = 0.770, p < 0.001), CDT and the ABCD Visuospatial Construction subdomain (r = 0.880, p < 0.001); while a negative correlation was found between CDT and IADL (r = -0.627, p < 0.001) between the CUG and the CIG groups.
Given the results obtained, the CDT appears to be a clinically valid screening instrument for the assessment of visuospatial abilities, with high reliability in Greek populations with cognitive impairment.
One hundred and thirty-two individuals participated in this study [60 with Good Cognitive Health (GCH), 24 with Parkinson\'s Disease (PD), 24 with Parkinson\'s Disease Dementia (PDD) and 24 with Alzheimer\'s Disease (AD)]. The CDT was administered to all participants. Additionally, the cognitive and mental status of the sample were estimated through the use of the Mini Mental State Examination (MMSE), Abbreviated Mental Test Score (AMTS), Arizona Battery for Communication Disorders of Dementia (ABCD), Instrumental Activities of Daily Living (IADL), the Neuropsychiatric Inventory (H-NPI) and the Geriatric Depression Scale -15 (GDS-15).
Statistically significant differences were found between all groups on the CDT, with AD patients having lower scores than all subgroups in the study. The CDT showed a high internal consistency (Cronbach\'s alpha = 0.832). The ROC analysis provided a cutoff point equal to 4.00 (AUC: 0.821, p < 0.001) between the Cognitively Unimpaired Group (CUG: GCH and PD group) and the Cognitively Impaired Group (CIG: PPD and AD patients), 5.00 (AUC: 0.845, p < 0.001) between the GCH group and the PDD group, and 4.00 (AUC: 0.780, p < 0.001) between the GCH group and the AD group. Finally, the cutoff point between the PD group and the PDD group was 4.00 (AUC: 0.896, p < 0.005), and 3.00 (AUC: 0.899, p < 0.001) between the PD group and the AD group. Significant positive Pearson\'s correlations were observed between CDT and MMSE (r = 0.808, p < 0.001), CDT and AMTS (r = 0.688, p < 0.001), CDT and ABCD (r = 0.770, p < 0.001), CDT and the ABCD Visuospatial Construction subdomain (r = 0.880, p < 0.001); while a negative correlation was found between CDT and IADL (r = -0.627, p < 0.001) between the CUG and the CIG groups.
Given the results obtained, the CDT appears to be a clinically valid screening instrument for the assessment of visuospatial abilities, with high reliability in Greek populations with cognitive impairment.
摘要：
本研究旨在首次验证Tuokko版本的时钟绘制测试（CDT），并在将其翻译成希腊语并在希腊人口中进行管理后估计其截止分数。
一百三十二个人参与了这项研究[60人认知健康良好（GCH），24患有帕金森病（PD），24例帕金森病痴呆(PDD)和24例阿尔茨海默病(AD)]。对所有参与者施用CDT。此外,通过使用迷你精神状态检查(MMSE)估计样本的认知和精神状态，缩略心理测验评分(AMTS),亚利桑那州老年痴呆症交流障碍电池（ABCD），日常生活工具活动（IADL），神经精神量表（H-NPI）和老年抑郁量表-15（GDS-15）。
在CDT上，所有组之间均存在统计学上的显着差异，AD患者的评分低于研究中的所有亚组。CDT显示出较高的内部一致性(Cronbach'sα=0.832)。ROC分析在认知未受损组（CUG：GCH和PD组）和认知受损组（CIG：PPD和AD患者）之间提供了等于4.00（AUC：0.821，p<0.001）的截止点，GCH组和PDD组之间为5.00（AUC：0.845，p<0.001），GCH组和AD组之间为4.00(AUC:0.780,p<0.001)。最后,PD组和PDD组之间的截止点为4.00（AUC：0.896，p<0.005），PD组和AD组之间为3.00(AUC:0.899,p<0.001)。在CDT和MMSE之间观察到显著的Pearson正相关(r=0.808,p<0.001),CDT和AMTS（r=0.688，p<0.001），CDT和ABCD（r=0.770，p<0.001），CDT和ABCD视觉空间构建子域（r=0.880，p<0.001）；而CUG和CIG组之间的CDT和IADL之间呈负相关（r=-0.627，p<0.001）。
鉴于获得的结果，CDT似乎是评估视觉空间能力的临床有效筛查工具，在希腊认知障碍人群中具有高可靠性。
一百三十二个人参与了这项研究[60人认知健康良好（GCH），24患有帕金森病（PD），24例帕金森病痴呆(PDD)和24例阿尔茨海默病(AD)]。对所有参与者施用CDT。此外,通过使用迷你精神状态检查(MMSE)估计样本的认知和精神状态，缩略心理测验评分(AMTS),亚利桑那州老年痴呆症交流障碍电池（ABCD），日常生活工具活动（IADL），神经精神量表（H-NPI）和老年抑郁量表-15（GDS-15）。
在CDT上，所有组之间均存在统计学上的显着差异，AD患者的评分低于研究中的所有亚组。CDT显示出较高的内部一致性(Cronbach'sα=0.832)。ROC分析在认知未受损组（CUG：GCH和PD组）和认知受损组（CIG：PPD和AD患者）之间提供了等于4.00（AUC：0.821，p<0.001）的截止点，GCH组和PDD组之间为5.00（AUC：0.845，p<0.001），GCH组和AD组之间为4.00(AUC:0.780,p<0.001)。最后,PD组和PDD组之间的截止点为4.00（AUC：0.896，p<0.005），PD组和AD组之间为3.00(AUC:0.899,p<0.001)。在CDT和MMSE之间观察到显著的Pearson正相关(r=0.808,p<0.001),CDT和AMTS（r=0.688，p<0.001），CDT和ABCD（r=0.770，p<0.001），CDT和ABCD视觉空间构建子域（r=0.880，p<0.001）；而CUG和CIG组之间的CDT和IADL之间呈负相关（r=-0.627，p<0.001）。
鉴于获得的结果，CDT似乎是评估视觉空间能力的临床有效筛查工具，在希腊认知障碍人群中具有高可靠性。
