Visual-spatial perception: a comparison between instruments frequently used in the primary care setting and a computerized cognitive assessment battery

Figures & data

Table 1 Characteristics of study participations (N=190)

Baseline variables	N	%
Sex
Male	79	41.6
Female	111	58.4
Age (years)
Range	67–94
Mean ± SD	81.09±5.42
Cognitive diagnosis
Normal	62	32.6
MCI	90	47.4
Dementia, total	38	20
Alzheimer type	27	71
Vascular type	9	23.8
Lewy body type	1	2.6
Others	1	2.6
Years of education
Range	0–25
Mean ± SD	13.83±10.02
Depression screening (by PHQ-9)
Total	127 (63 missing data)
Range	1–27
Mean ± SD	12.9±6.6
Basic Activity of Daily Living (BADL)
Total	154 (36 missing data)
Range	35–100
Mean ± SD	92.06±11.89
Instrumental Activity of Daily Living (IADL)
Total	146 (44 missing data)
Range	0–14
Mean ± SD	9.60±3.55
Charlson combined score (with age)
Range	3–11
Mean ± SD	5.28±1.65
Total CIRS-G score
Range	4–19
Mean ± SD	10.91±4.66
Severity index (total CIRS-G score/total number of categories endorsed)
Range	1.3–2.6
Mean ± SD	1.99±0.27

Abbreviations: SD, standard deviation; MCI, mild cognitive impairment; PH Q-9, Patient Health Questionnaire-9; CIRS-G, cumulative illness rating scale – geriatric version.

Table 2 Selected outcomes cognitive assessment of study population

Cognitive assessment	N	%
Neurotrax
Global score
Normal	83	43.7
Abnormal	107	56.3
Mean ± SD	84.75±12.34
Range	55.9–112.1
Visual-spatial index
Normal	92	48.4
Abnormal	98	51.6
Mean ± SD	87.43±13.07
Range	62.5–128.4
Cube Test
Normal	126	66.3
Abnormal	64	33.7
Trail Making B test
Normal	80	42.1
Abnormal	110	57.9
Pentagon Copying
Normal	73	38.4
Abnormal	117	61.6
Clock Drawing Test
Normal	98	51.6
Abnormal	92	48.4

Abbreviation: SD, standard deviation.

Table 3 Comparison between single tools and visual score of Neurotrax test for evaluation of visual-spatial ability

Type of tests	Neurotrax visual-spatial index					Sensitivity(%)	Specificity (%)	PPV (%)	NPV (%)
	Abnormal (≤85), N=98		Normal (>85), N=92		P-value
	N	%	N	%
Cube Test
Abnormal	39	39.8	25	27.2	0.091	39.8	72.8	60.9	53.2
Normal	59	60.2	67	72.8
Trail Making B test
Abnormal	71	72.4	39	42.4	<0.0001	72.4	57.6	64.5	66.3
Normal	27	27.6	53	57.6
Pentagon Copying
Abnormal	67	68.4	50	54.3	0.053	68.4	45.7	57.3	57.5
Normal	31	31.6	42	45.7
Clock Drawing Test
Abnormal	64	65.3	34	37.0	<0.0001	65.3	63.0	65.3	63.0
Normal	34	34.7	58	63.0

Abbreviations: PPV, positive predictive value; NPV, negative predictive value.

Table 4 Comparison between two integrated single tools and visual score of Neurotrax test for evaluation of visual-spatial ability

Combinations of tests	Neurotrax visual-spatial index					Sensitivity(%)	Specificity (%)	PPV (%)	NPV (%)
	Abnormal (≤85), N=98		Normal (≤85), N=92		P-value
	N	%	N	%
Trail B + Cube Test
Abnormal	73	74.5	42	45.7	<0.0001	74.5	54.3	63.5	66.7
Normal	25	25.5	50	54.3
CDT + Cube Test
Abnormal	72	73.5	43	46.7	<0.0001	73.5	53.3	62.6	65.3
Normal	26	26.5	49	53.3
CDT + Trail B
Abnormal	83	84.7	51	55.4	<0.0001	84.7	44.6	61.9	73.2
Normal	15	15.3	41	44.6
Trail B + Pentagon Copying
Abnormal	86	87.8	61	66.3	<0.0001	87.8	33.7	58.5	72.1
Normal	12	12.2	31	33.7
CDT + Pentagon Copying
Abnormal	81	82.7	59	64.1	<0.001	82.7	35.9	57.9	66.0
Normal	17	17.3	33	35.9
Cube + Pentagon Copying
Abnormal	74	75.5	52	56.5	<0.001	75.5	43.5	58.7	62.5
Normal	24	24.5	40	43.5

Abbreviations: PPV, positive predictive value; NPV, negative predictive value; CDT, Clock Drawing Test.

Table 5 Comparison between three and four integrated tools and visual score of Neurotrax test for evaluation of visual-spatial ability

Type of tests	Neurotrax visual-spatial index					Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)
	Abnormal (≤85), N=98		Normal (≤85), N=98		P-value
	N	%	N	%
Cube + Pentagon + Trail B
Abnormal	87	88.8	61	66.3	<0.0001	88.8	33.7	58.8	73.8
Normal	11	11.2	31	33.7
CDT + Cube + Pentagon	+ Trail B
Abnormal	92	93.9	67	72.8	<0.0001	93.9	27.2	57.9	80.6
Normal	6	6.1	25	27.2

Abbreviations: PPV, positive predictive value; NPV, negative predictive value; CDT, Clock Drawing Test.

Table 6 Sensitivity and specificity of individual tests compared with clinical diagnosis

Type of tests	Diagnosis					Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)
	MCI/dementia (N=128)		Normal (N=62)		P-value
	N	%	N	%
Cube Test
Abnormal	49	38.3	15	24.2	0.07	38.3	75.8	76.6	37.3
Normal	79	61.7	47	75.8
	128		62
Trail B test
Abnormal	80	62.5	30	48.4	0.08	62.5	51.6	72.7	40.0
Normal	48	37.5	32	51.6
	128		62
Pentagon
Abnormal	79	61.7	38	61.3	1.0	61.7	38.7	67.5	32.9
Normal	49	38.3	24	38.7
	128		62
CDT total
Abnormal	74	57.8	24	38.7	0.02	57.8	61.3	75.5	41.3
Normal	54	42.2	38	61.3
	128		62
Neurotrax exam total score
Abnormal	84	65.6	23	37.1	<0.01	65.6	62.9	78.5	47.0
Normal	44	34.4	39	62.9
	128		62

Abbreviations: PPV, positive predictive value; NPV, negative predictive value; MCI, mild cognitive impairment; CDT, Clock Drawing Test.