Development of the four-item Letter and Shape Drawing test (LSD-4): A brief bedside test of visuospatial function

Olugbenga Alaba Williams; Henry O'Connell; Maeve Leonard; Fahad Awan; Debbie White; Frank McKenna; Ailish Hannigan; Walter Cullen; Chris Exton; Walter Enudi; Colum Dunne; Dimitrios Adamis; David Meagher

doi:10.1016/j.psychres.2016.12.004

Development of the four-item Letter and Shape Drawing test (LSD-4): A brief bedside test of visuospatial function

Psychiatry Res. 2017 Jan:247:317-322. doi: 10.1016/j.psychres.2016.12.004. Epub 2016 Dec 5.

Authors

Affiliations

¹ Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland; Department of Psychiatry, University Hospital Limerick, Ireland.
² Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland; Laois-Offaly Mental Health services, St Fintan's Hospital, Portlaoise, Ireland.
³ Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland.
⁴ Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland; Department of General Practice, School of Medicine, University College Dublin, Ireland.
⁵ Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland; Laois-Offaly Mental Health services, St Fintan's Hospital, Portlaoise, Ireland.
⁶ Graduate Entry Medical School, University of Limerick, Ireland; Sligo Mental Health Services, Ballytivan Road, Sligo, Ireland.
⁷ Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Graduate Entry Medical School, University of Limerick, Ireland; Department of Psychiatry, University Hospital Limerick, Ireland. Electronic address: [email protected].

PMID: 27951480
DOI: 10.1016/j.psychres.2016.12.004

Abstract

Conventional bedside tests of visuospatial function such as the Clock Drawing (CDT) and Intersecting Pentagons (IPT) lack consistency in delivery and interpretation. We compared performance on a novel test of visuospatial ability - the LSD - with the IPT, CDT and MMSE in 180 acute elderly medical inpatients [mean age 79.7±7.1 (range 62-96); 91 females (50.6%)]. 124 (69%) scored ≤23 on the MMSE; 60 with mild (score 18-23) and 64 with severe (score ≤17) impairment. 78 (43%) scored ≥6 on the CDT, while for the IPT, 87 (47%) scored ≥4. The CDT and IPT agreed on the classification of 138 patients (77%) with modest-strong agreement with the MMSE categories. Correlation between the LSD and visuospatial tests was high. A four-item version of the LSD incorporating items 1,10,12,15 had high correlation with the LSD-15 and strong association with MMSE categories. The LSD-4 provides a brief and easily interpreted bedside test of visuospatial function that has high coverage of elderly patients with neurocognitive impairment, good agreement with conventional tests of visuospatial ability and favourable ability to identify significant cognitive impairment. [181 words].

Keywords: Assessment Letter and Shape Drawing Test (LSD); Cognition; Phenomenology.

Publication types

Comparative Study

MeSH terms

Aged
Aged, 80 and over
Cognition Disorders / diagnosis*
Cognition Disorders / psychology
Female
Humans
Inpatients / psychology*
Male
Middle Aged
Neuropsychological Tests*
Point-of-Care Testing*
Reproducibility of Results
Spatial Processing*