Bicycle Drawing Test – Validation Study for Dementia
Authors:
E. Bolceková 1,2,3; K. Čechová 1,3; H. Marková 4; S. Johanidesová 5; H. Štěpánková 3; M. Kopeček 3
Authors‘ workplace:
Katedra psychologie, FF UK v Praze
1; Neurologická klinika a Centrum klinických neurověd 1. LF UK a VFN v Praze
2; Národní ústav duševního zdraví, Klecany
3; Kognitivní centrum, Neurologická klinika 2. LF UK a FN v Motole, Praha
4; Laboratoř evokovaných potenciálů, neurologické oddělení, Thomayerova nemocnice, Praha
5
Published in:
Cesk Slov Neurol N 2016; 79/112(4): 416-423
Category:
Original Paper
Overview
Aims:
The Bicycle Drawing Test (BDT) is used in neuropsychological assessment to evaluate visuospatial and executive functions. Administration and scoring are short and simple. The aim of this project was to examine psychometric properties of the BDT (reliability, validity) and the effect of demographic characteristics and to present results of healthy older adults. A secondary aim was to compare two different scoring systems.
Methods:
We evaluated 111 drawings of cognitively healthy adults aged over 60 (age M = 74.4 years, SD = 7.8; education M = 13.5 years, SD = 3.6) and 57 drawings of patients with cognitive deficit (age M = 75.6 years, SD = 7.3; education M = 13.8 years, SD = 3.3). The group with cognitive deficit included patients with mild cognitive impairment, dementia due to Alzheimer’s disease, and other dementias. All subjects completed a detailed neuropsychological battery. Drawings were scored according to Lezak’s and Greenberg’s systems.
Results:
We present values for inter-rater reliability, item-total correlation and internal consistency. Scores were not influenced by age or education but differed by gender. Convergent and divergent validity analysis showed correlation with measures of visuospatial and executive functions and with global cognitive functioning, and lack of correlation with memory or language measures. We found satisfactory discriminative power of BDT for detection of dementia but not for MCI.
Conclusions:
Psychometric properties of BDT substantiate its use in clinical practice for evaluation of visuospatial functions and global cognition level. Presented values for transformation of raw scores into standard scores allow clinicians to work with quantitative rating of results.
Key words:
Bicycle Drawing Test – visuospatial function – executive function – reliability – validity
The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.
Sources
1. Piaget J. The child‘s conception of physical causality. London: Kegan Paul, Trench, Trubner 1930.
2. Lezak MD, Howieson DB, Bigler ED, et al. Neuropsychological assessment. 5th ed. New York: Oxford University Press 2012.
3. Blair M, Kertesz A, McMonagle P, et al. Quantitative and qualitative analyses of clock drawing in frontotemporal dementia and Alzheimer‘s disease. J Int Neuropsychol Soc 2006;12(2):159– 65.
4. Tranel D, Rudrauf D, Vianna EP, et al. Does the clock drawing test have focal neuroanatomical correlates? Neuropsychology 2008;22(5):553– 62. doi: 10.1037/ 0894-4105.22.5.553.
5. Rabin LA, Barr WB, Burton LA. Assessment practices of clinical neuropsychologists in the United States and Canada: a survey of INS, NAN, and APA division 40 members. Arch Clin Neuropsychol 2005;20(1):33– 65.
6. Freedman M, Leach L, Kaplan E, et al. Clock drawing: a neuropsychological analysis. Oxford University Press 1994.
7. Rubinova E, Nikolai T, Markova H, et al. Clock Drawing Test and the diagnosis of amnestic mild cognitive impairment: can more detailed scoring systems do the work? J Clin Exp Neuropsychol 2014;36(10):1076– 83. doi: 10.1080/ 13803395.2014.977233.
8. Štěpánková H, Bezdíček O, Nikolai T, et al. Zpráva o projektu Národní normativní studie kognitivních determinant zdravého stárnutí. E-psychologie 2015;9(1):43– 6.
9. Bezdiček O, Michalec J, Nikolai T, et al. ValiditaMontrealského kognitivního testu pro detekci mírne kognitivní poruchy u Parkinsonovy nemoci. Cesk SlovNeurol N 2014;77/110(1):47–53.10. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med 2004;256(3):183– 94.
11. Nikolai T, Bezdícek O, Vyhnálek M, et al. Mírná kognitivní porucha: diagnostická jednotka nebo stadium předcházející demenci? Cesk Slov Psychol 2012;56(4): 374– 90.
12. McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to alzheimer’s disease: recommendations from the national institute on aging-alzheimer’s association workgroups on diagnostic guidelines for Alzheimer‘s disease. Alzheimers Dement 2011;7(3):263– 9. doi: 10.1016/ j.jalz.2011.03.005.
13. Greenberg GD, Rodriguez NM, Sesta JJ. Revised scoring, reliability, and validity investigations of Piaget‘s bicycle drawing test. Assessment 1994;1(1):89– 101.
14. Štěpánková H, Nikolai T, Lukavský J, et al. Mini-Mental State Examination – česká normativní studie. Cesk Slov Neurol N 2015;78/ 111(1):57– 63.
15. Randolph C. Repeatable battery for the assessment of neuropsychological status (RBANS). San Antonio: Psychological Corporation 1998.
16. Dubois B, Slachevsky A, Litvan I, et al. The FAB a frontal assessment battery at bedside. Neurology 2000;55(11):1621– 6.
17. Bezdicek O, Motak L, Axelrod BN, et al. Czech version of the Trail Making Test: normative data and clinical utility. Arch Clin Neuropsychol 2012;27(8):906– 14. doi: 10.1093/ arclin/ acs084.
18. Kopeček M, Štěpánková H. Test-retest minutové slovní produkce v kategorii zvířata a kratších variant u seniorů. Psychiatrie 2009;13(2– 3):61– 5.
19. Nikolai T, Michalec J, Bezdíček O, et al. Normative Data on Verbal Fluency in Very Old Czech Adults. Cesk Slov Neurol 2015;78/111(3):292–9.
20. Johanidesová S, Bolceková E, Štepánková H, et al. Test neverbální fluence – five point test: normativní data pro dospělé. Cesk Slov Neurol N 2014;77/ 110(6):704– 13.
21. Bezdicek O, Lukavsky J, Stepankova H, et al. The Prague Stroop Test: normative standards in older Czech adults and discriminative validity for mild cognitive impairment in Parkinson’s disease. J Clin Exp Neuropsychol 2015;37(8):794– 807. doi: 10.1080/ 13803395.2015.1057106.
22. Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979;134(4):382– 9.
23. Cummings JL, Mega M, Gray K, et al. The neuropsychiatric inventory comprehensive assessment of psychopathology in dementia. Neurology 1994;44(12):2308– 14.
24. Bezdíček O, Lukavský J, Preiss M. Validizační studie české verze dotazníku FAQ. Cesk Slov Neurol N 2011;74/ 107(1):29– 35.
25. R core team. R: a language and environment for statistical computing. R foundation for statistical computing, Vienna, Austria 2014. [online]. Available from URL: www.R-project.org.
26. Diederich C, Merten T. Fahrrad-zeichen-tests und ihr einsatz in der neuropsychologischen diagnostik. Zeitschrift für Neuropsychologie 2009;20:304.
27. Schmitt AL, Livingston RB, Galusha JM, et al. Correlation between the bicycle drawing task and neuropsychological variables in patients referred for a dementia evaluation. Percept Mot Skills 2009;109(3):721– 30.
28. Hubley AM, Hamilton L. Using the bicycle drawing test with adults. Miami, Florida 2002.
29. Collaer ML, Nelson JD. Large visuospatial sex difference in line judgment: possible role of attentional factors. Brain Cog 2002; 49(1): 1-12.
30. Weiss E, Siedentopf CM, Hofer A, et al. Sex differences in brain activation pattern during a visuospatial cognitive task: a functional magnetic resonance imaging study in healthy volunteers. Neuroscience Letters 2003;344(3):169– 72.
31. Bolceková E, Čechová K, Marková H, et al. Criterion validity of the bicycle drawing test in patients with cognitive deficit. In: H. Štěpánková, R. Šlamberová, eds. Stárnutí 2014: Sborník příspěvků z Gerontologické mezioborové konference 3. LF UK v Praze, 24.–25. října 2014 (pp. 10–18). Praha: 3. LF UK v Praze. [online]. Dostupné z URL: http://www.konferencestarnuti.cz/files/Starnuti_2014_sbornik.pdf.
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Paediatric neurology Neurosurgery NeurologyArticle was published in
Czech and Slovak Neurology and Neurosurgery
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