Research articles

By Mr. Sayak Chatterjee , Ms. Sheela Chandrashekar , Ms. Krystal Kan , Ms. Lauren E Drake , Mr. Anil K Nair
Corresponding Author Mr. Anil K Nair
Quincy Medical Center, Alzheimer's Disease Center, 114 Whitwell St - United States of America 02169
Submitting Author Mr. Anil K Nair
Other Authors Mr. Sayak Chatterjee
Alzheimers Disease Center, - United States of America

Ms. Sheela Chandrashekar
Alzheimer Disease Center, - United States of America

Ms. Krystal Kan
Alzheimers Disease Center, - United States of America

Ms. Lauren E Drake
Alzheimers Disease Center, - United States of America


Alzheimer, dementia, cube, copy, test, neuropsychology, diagnosis, cognitive, screening, MOCA

Chatterjee S, Chandrashekar S, Kan K, Drake LE, Nair AK. Can Correctly Drawn Necker Cube-Copy Lines Predict Clinical Diagnosis among Memory Clinic Population?. WebmedCentral AGING 2018;9(3):WMC003864

This is an open-access article distributed under the terms of the Creative Commons Attribution License(CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Submitted on: 01 Dec 2012 01:52:10 PM GMT
Published on: 07 Mar 2018 05:58:23 AM GMT


The Necker cube test is a cognitive screening test used for the detection of dementias. We used a simple scoring method, where only the correctly drawn lines were scored, to predict dementia diagnoses at memory clinic. There was significant correlation between the number of correctly drawn cube lines, to age and diagnosis. Multivariate linear modeling showed this simple scoring differentiated Alzheimer dementia from other dementia diagnoses and mild cognitive impairment in patients. Quantifying Necker cube test can be a useful adjunct for diagnosis in a memory clinic.


Copying a cube is a simple pen and paper test that is widely used for detecting dementia. It is used in well known screening batteries, such as the Short Test of Mental Status [1] and Bender Gestalt Test [2]. The shape used is an optical illusion of a cube; a wireframe drawing of a cube in isometric perspective that was first published by the Swiss crystallographer Louis Albert Necker in 1832. When the parallel lines in the cube cross, there is some ambiguity such that, it is unclear which is in front and which is behind. Additional information, required for visualizing the three diminutional perspective is supplied by cortex, such that most persons see one interpretation of the cube, and some even experience "flipping" of the perspective of the cube. [3] Most persons see the lower-left face as being in front, with the top side visible. [4]

One can imagine this task is much more difficult for a patient with dementia as the cortical information supplied may be less than those without dementia. [1] While the cube-copying test is useful for routine clinical dementia screening, it is unknown if more information could be accrued from it for utility in screening for earlier and preclinical stages of dementia. The test examines more than one aspect of cognitive function, such as line orientation, complicated parietal and occipital visual processing, and is easily quantified.

At we are interested in adapting existing neuropsychological tests for use in what is currently considered prodromal or pre-clinical dementia. In this study we set out to examine if counting the number of lines correctly drawn while copying the Necker cube can provide a rough estimate of cognitive dysfunction in our dementia patients. We wanted to clarify whether a simple quantitative scoring of the cube-copying test, used in isolation, could rapidly assess early dementia in patients by predicting cognitive test performance and diagnosis.

Source(s) of Funding

Massachusetts State Funding MSLC Grant to Alzheimers Disease Center.

Competing Interests


0 reviews posted so far

0 comments posted so far

Please use this functionality to flag objectionable, inappropriate, inaccurate, and offensive content to WebmedCentral Team and the authors.


Author Comments
0 comments posted so far


What is article Popularity?

Article popularity is calculated by considering the scores: age of the article
Popularity = (P - 1) / (T + 2)^1.5
P : points is the sum of individual scores, which includes article Views, Downloads, Reviews, Comments and their weightage

Scores   Weightage
Views Points X 1
Download Points X 2
Comment Points X 5
Review Points X 10
Points= sum(Views Points + Download Points + Comment Points + Review Points)
T : time since submission in hours.
P is subtracted by 1 to negate submitter's vote.
Age factor is (time since submission in hours plus two) to the power of 1.5.factor.

How Article Quality Works?

For each article Authors/Readers, Reviewers and WMC Editors can review/rate the articles. These ratings are used to determine Feedback Scores.

In most cases, article receive ratings in the range of 0 to 10. We calculate average of all the ratings and consider it as article quality.

Quality=Average(Authors/Readers Ratings + Reviewers Ratings + WMC Editor Ratings)