Yamaguchi Fox-Pigeon Imitation Test: A Rapid Test for Dementia

Background/Aims: We herein propose a hand-gesture imitation test, consisting of a simple one-handed sign of a ‘fox’ and a complex two-handed sign of a ‘pigeon’, as a rapid, game-like test for detecting dementia/Alzheimer disease (AD) with low psychological burden. The test measures the visuomotor function, which deteriorates in the early stages of AD. Methods: We examined 88 demented subjects, 19 with mild cognitive impairment (MCI), and 53 normal controls aged 65 years or over. The subjects were classified according to the Clinical Dementia Rating (CDR). Results: The specificity of the test was 94%, and the sensitivity was 58% in CDR 0.5 (MCI), 77% in CDR 1 (mild dementia), 75% in CDR 2 (moderate dementia), and 90% in CDR 3 (severe dementia). The test could be conducted within 1 min and no subjects refused to be tested. Conclusion: This brief hand-gesture imitation test can sensitively evaluate visuomotor deficits in dementia/AD, while some subjects are unaware of their failure or even that their cognitive function is being tested. We herein describe the precise protocol for worldwide use.

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