The Complex Picture Test in Dementia

The newly developed Complex Picture Test (CPT) examines main cognitive domains, especially perceptual and visual-spatial abilities. The potential usefulness of the CPT in the assessment of dementia was evaluated. Patients with different forms of dementia [14 vascular dementia (VaD), 30 Alzheimer's disease (AD), 6 Parkinson's disease dementia (PDD)], 12 subjects with mild cognitive impairment (MCI), and 30 matched controls were examined by the CPT, Mini-Mental State Examination (MMSE), the WAIS-R Digit Span subtest, and the Clock Drawing Test (CDT). The CPT consists of 10 complex pictures, each presenting characteristics paradoxically in opposition to each other. The subjects scored points for naming the object and noticing the paradox. One point was added for commenting on the paradox without prompting (3 points each picture/maximum of 30). CPT scores were significantly higher in the control group (mean ± SD, 29.46 ± 1.43) than in the AD, VaD, MCI, and PDD groups (13.1 ± 2.3, 16.9 ± 3.5, 23.2 ± 1.4, and 23.6 ± 3.4, respectively; p < 0.05). Significant positive correlations between MMSE, Digit Span, CDT, and CPT scores were observed (rho 0.76, 0.35, and 0.56, respectively). These data show perception of complex pictures being compromised in dementia. The correlation between CPT scores and MMSE scores suggests that tests may be used as a brief screening tool for dementia.