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Neurol India. 2018 Nov-Dec;66(6):1644-1648. doi: 10.4103/0028-3886.246242.

A new scoring system and norms for, and the performance of cognitively-unimpaired older adults on the cube copying test.

Author information

Department of Neurology, Pushpagiri Institute for Medical Sciences, Thiruvalla, Kerala, India.
Department of Psychology, UC College, Aluva, Kerala, India.
Department of Neurology, National Institute for Mental Health and Neurosciences, Bengaluru, Karnataka, India.



Cube copying test is often used as screening test for dementia. However, there is a paucity of an effectively scoring system, and very little is known about how healthy older adults perform on this test. In this study, we present a modified scoring system for the wire-cube copying, evaluate the performance of cognitively unimpaired elderly individuals, and generate norms on community-dwelling older adults.

Materials and Methods:

The task consisted of copying a three-dimensional printed cube (i.e., wire-cube) of size 2.5 cm3. The scoring system devised by Maeshma et al. was modified and used. The target population consisted of cognitively normal individuals aged ≥65 years living in a predefined geographical area.


In this study, there were 511 participants (62% females) aged 69 ± 7.2 years. Of the 295 figures available, 51 were rejected. Among the candidates with acceptable cubes, 182 (74.5%) had ≥9 years of education. Of the 51 rejected cubes, 37 (72.5%) participants had <9 years of education. Education was found to be significantly correlated with composite score (P < 0.001) whereas age and sex had no correlation. The total score as well as subgroup scores of the cubes were correlating well with Mini-mental state examination (MMSE) as well as Addenbrooke's Cognitive Examination (ACE) composite scores (P < 0.0001).


Good correlation was found between composite scores and subscores with most of the ACE parameters. The test can be used as a rapid screening test for dementia in view of its good correlation with ACE composite scores and subscores; it also has the advantage of being independent of culture and language.


Construction; cube copying; dementia screening

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