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The Usefulness of Cube Copying for Evaluating Treatment of Alzheimer's Disease

Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, University Hospital MAS, Malmö, Sweden, sebastian.palmqvist{at}skane.se

Oskar Hansson, MD, PhD

Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, University Hospital MAS, Malmö, Sweden

Lennart Minthon, MD, PhD

Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, University Hospital MAS, Malmö, Sweden

Elisabet Londos, MD, PhD

Aims: Cube copying measures visuospatial ability, which is often impaired in Alzheimer's disease (AD). Cube copying was examined as an evaluation of cholinesterase inhibitor (ChEI) treatment in AD. Methods: Eighty-five ChEI-treated AD patients were included. Cube drawings made at prebaseline, baseline, 6 months, and 12 months were assessed. Cube drawings from 56 healthy individuals were also examined. Results: The healthy individuals remained stable in cube copying, whereas untreated AD patients deteriorated during a median period of 6 months. When treatment was given, the deterioration was interrupted. After 12 months, Mini-Mental State Examination (MMSE) had deteriorated compared with baseline whereas cube copying was unchanged.

Conclusions: The results indicate that cube copying can be used to evaluate ChEI treatment. It might also show a more long-lasting response to treatment than MMSE. Cube copying only measures a narrow cognitive function and can preferably be used with MMSE, which evaluates visuospatial ability poorly.

Key Words: Alzheimer's disease • cube copying • cholinesterase inhibitors • treatment outcome • box copying • Necker cube

American Journal of Alzheimer's Disease and Other Dementias®, Vol. 23, No. 5, 439-446 (2008)
DOI: 10.1177/1533317508320084


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