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Article type: Research Article
Authors: Heymann, Petraa | Gienger, Reginea | Hett, Andreasa | Müller, Stephanb | Laske, Christophb | Robens, Sibyllec | Ostermann, Thomasc | Elbing, Ulricha; *
Affiliations: [a] Institute for Research and Development in the Art Therapies Nürtingen-Geislingen University, Nürtingen, Germany | [b] Department of Psychiatry and Psychotherapy, Eberhard Karls University, Tübingen, Germany | [c] Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
Correspondence: [*] Correspondence to: Prof. Dr. Ulrich Elbing, Institute for Research and Development in the Art Therapies, Nürtingen-Geislingen University, Sigmaringer Str.15/2, 72622 Nürtingen, Germany. Tel.: +49 0 7022 9333615; E-mail: [email protected].
Abstract: Based on the knowledge of art therapy, we developed a new neuropsychological drawing test in order to identify individuals with mild cognitive impairment (MCI) as well as dementia patients and healthy controls (HC). By observing a variety of drawing characteristics of 92 participants with a mean age of 67.7, art therapy and dementia experts discriminate HC from MCI, early dementia of the Alzheimer-type (eDAT), and moderate dementia of the Alzheimer-type (mDAT) by the process analysis of tree drawings on a digitizing tablet. The art therapist’s average categorical rating of healthy and MCI or demented individuals matched the clinical diagnosis by 88%. In a first small study, we analyzed interrater reliability, sensitivity, specificity, negative and positive predicted values of our tree drawing test (TDT) in comparison with the clock drawing test (CDT). Similar values of moderate interrater reliability were found for the TDT (0.56) as well as for the CDT (0.54). A significant high sensitivity of 0.9 within this binary impairment scale (HC versus impaired or demented) can be demonstrated. Substantial values for the specificity (0.67) could be obtained that however remain under a perfect value of the CDT (1.0). Considering 31 individuals that received the clinical diagnosis “impaired or demented” the TDT shows a higher recognition rate for the MCI group than the CDT. Furthermore in 8 of 12 borderline cases of clinical diagnosis, the outcome of the TDT diagnosis was consistent with the final clinical result.
Keywords: Art therapist raters, dichotomous classification, drawing characteristics, early Alzheimer’s disease, mild cognitive impairment, neuropsychological drawing test, screening, tablet-based
DOI: 10.3233/JAD-170946
Journal: Journal of Alzheimer's Disease, vol. 63, no. 2, pp. 675-687, 2018
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