scholarly journals Mapping the clockworks: what does the Clock Drawing Test assess in normal and pathological aging?

2013 ◽  
Vol 71 (10) ◽  
pp. 763-768 ◽  
Author(s):  
Jonas Jardim de Paula ◽  
Debora Marques de Miranda ◽  
Edgar Nunes de Moraes ◽  
Leandro Fernandes Malloy-Diniz
Keyword(s):  
Executive Functions ◽  
Test Performance ◽  
Semantic Knowledge ◽  
Cognitive Status ◽  
Cognitive Screening ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Cognitive Components ◽  
Drawing Test

The Clock Drawing Test (CDT) is a cognitive screening tool used in clinical and research settings. Despite its role on the assessment of global cognitive functioning, the specific cognitive components required for test performance are still unclear. We aim to assess the role of executive functioning, global cognitive status, visuospatial abilities, and semantic knowledge on Shulman’s CDT performance. Fifty-three mild cognitive impairment, 60 Alzheimer’s dementia, and 57 normal elderly controls performed the CDT, the Frontal Assessment Battery, the Mini-Mental State Examination, the Stick Design Test, and a naming test (TN-LIN). An ordinal regression assessed specific neuropsychological influences on CDT performance. All the cognitive variables were related to the CDT, accounting for 53% of variance. The strongest association was between the CDT and executive functions, followed by global cognitive status, visuospatial processing, and semantic knowledge. Our result confirms the multidimensional nature of the test and the major role of executive functions on performance.

scholarly journals The Clock Drawing Test: Performance differences between the free-drawn and incomplete-copy versions in patients with MCI and dementia

2016 ◽  
Vol 10 (3) ◽  
pp. 227-231 ◽  
Author(s):  
Bárbara Costa Beber ◽  
Renata Kochhann ◽  
Bruna Matias ◽  
Márcia Lorena Fagundes Chaves
Keyword(s):  
Cognitive Impairment ◽  
Test Performance ◽  
Diagnostic Value ◽  
Control Group ◽  
Cognitive Screening ◽  
Scoring Method ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Healthy Elderly ◽  
Drawing Test

ABSTRACT Background: The Clock Drawing Test (CDT) is a brief cognitive screening tool for dementia. Several different presentation formats and scoring methods for the CDT are available in the literature. Objective: In this study we aimed to compare performance on the free-drawn and "incomplete-copy" versions of the CDT using the same short scoring method in Mild Cognitive Impairment (MCI) and dementia patients, and healthy elderly participants. Methods: 90 participants (controlled for age, sex and education) subdivided into control group (n=20), MCI group (n=30) and dementia group (n=40) (Alzheimer's disease - AD=20; Vascular Dementia - VD=20) were recruited for this study. The participants performed the two CDT versions at different times and a blinded neuropsychologist scored the CDTs using the same scoring system. Results: The scores on the free-drawn version were significantly lower than the incomplete-copy version for all groups. The dementia group had significantly lower scores on the incomplete-copy version of the CDT than the control group. MCI patients did not differ significantly from the dementia or control groups. Performance on the free-drawn copy differed significantly among all groups. Conclusion: The free-drawn CDT version is more cognitively demanding and sensitive for detecting mild/early cognitive impairment. Further evaluation of the diagnostic value (accuracy) of the free-drawn CDT in Brazilian MCI patients is needed.

scholarly journals The Clock Drawing Test: performance among elderly with low educational level

2008 ◽  
Vol 30 (4) ◽  
pp. 309-315 ◽  
Author(s):  
Roberto Alves Lourenço ◽  
Sergio Telles Ribeiro-Filho ◽  
Irene de Freitas Henriques Moreira ◽  
Emylucy Martins Paiva Paradela ◽  
Aline Sobral de Miranda
Keyword(s):  
Test Performance ◽  
Educational Level ◽  
Cognitive Status ◽  
Design Criterion ◽  
Formal Schooling ◽  
Rater Reliability ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test ◽  
Study Results

OBJECTIVE: To compare the accuracy of four scales, and to determine the inter-rater reliability and the influence of schooling on Clock Drawing Test performance in screening for dementia in elderly with low educational level. METHOD: Design: Criterion validation, concurrent type. Setting: Outpatient unit of Universidade do Estado do Rio de Janeiro Hospital, Brazil. Participants: A total of 306 individuals (> 65 years) were assessed by a geriatrician and a neuropsychologist using functional and cognitive instruments. The diagnosis of dementia was established by consensus in a meeting between these professionals. Four different researchers blinded as to the cognitive status of the patients scored the Clock Drawing Test using Shulman's, Sunderland's, Manos', and Wolf-Klein's methods; and a fifth researcher assessed Manos' method for an inter-rater reliability study. RESULTS: The data of 211 individuals (≤ 4 years of schooling) were analyzed. The sensitivity and specificity of the four methods were similar (about 65%). The inter-rater reliability of Manos' method was excellent (ICC = 0.944). The areas under the ROC curves were small (0.657 to 0.681), and the differences between them were not statistically significant. CONCLUSIONS: The Clock Drawing Test is a reliable but not valid test to screen for dementia in older outpatients with 4 or less years of formal schooling.

scholarly journals THink: Inferring Cognitive Status from Subtle Behaviors

AI Magazine ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 49-60 ◽  
Author(s):  
Randall Davis ◽  
David Libon ◽  
Roda Au ◽  
David Pitman ◽  
Dana Penney
Keyword(s):  
Neuropsychological Testing ◽  
Cognitive Status ◽  
Major Advance ◽  
Test Results ◽  
Clock Drawing Test ◽  
The Past ◽  
Drawing Test ◽  
Testing Technology ◽  
Opening Up

The digital clock drawing test is a fielded application that provides a major advance over existing neuropsychological testing technology. It captures and analyzes high precision information about both outcome and process, opening up the possibility of detecting subtle cognitive impairment even when test results appear superficially normal. We describe the design and development of the test, document the role of AI in its capabilities, and report on its use over the past seven years. We outline its potential implications for earlier detection and treatment of neurological disorders. We set the work in the larger context of the THink project, which is exploring multiple approaches to determining cognitive status through the detection and analysis of subtle behaviors.

scholarly journals COGNITIVE FUNCTIONS CONDITION OF POST-STROKE PATIENTS

2019 ◽  
pp. 16-21
Author(s):  
V. R. Gerasymchuk ◽  
I. F. Uwa-Agbonikhena ◽  
L. T. Maksymchuk ◽  
M. Yu. Kupnovytska-Sabadosh ◽  
T. I. Nehrych ◽  
...  
Keyword(s):  
Executive Functions ◽  
Mini Mental State Examination ◽  
Cognitive Status ◽  
Control Group ◽  
Clock Drawing Test ◽  
Drawing Test ◽  
Status Assessment ◽  
Trail Making ◽  
State Examination ◽  
Moca Score

60 patients after a hemispheric ischemic stroke (IS) were examined. Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Trail Making Test A and B (TMT), and the Clock Drawing Test (CDT) were used for the cognitive status assessment. A decrease in the MMSE, FAB and MoCA score compared to the control group (CG) (p<0.05) was observed, with probable differences mainly in the domains of attention (p<0.05) and executive functions (p<0.05). An increase in the time of task execution by 45.5% was detected for TMT A (p <0.05) and 61.9% for TMT B (p <0.01), and violation of CDT performance compared to the CG (p<0.05). Thus, the study of cognitive status using TMT and CDT may be recommended for timely detection of the initial executive functions impairment.

UTILITY OF THE CLOCK DRAWING TEST AS COGNITIVE SCREENING IN PATIENTS WITH ARTERIAL HYPERTENSION

2018 ◽  
Vol 36 (Supplement 1) ◽  
pp. e127-e128
Author(s):  
A. Vicario ◽  
G.H. Cerezo ◽  
P. Conti ◽  
P. Forcada ◽  
A.E. De Cerchio ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Cognitive Screening ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test

Is the Clock Drawing Test a screening tool for the diagnosis of mild cognitive impairment? A systematic review

2009 ◽  
Vol 22 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Lena Ehreke ◽  
Melanie Luppa ◽  
Hans-Helmut König ◽  
Steffi G. Riedel-Heller
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Literature Search ◽  
Screening Tool ◽  
Cognitive Screening ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test ◽  
Diagnosis Of Dementia ◽  
Mean Differences

ABSTRACTBackground:The clock drawing test (CDT) is a common and widely used cognitive screening instrument for the diagnosis of dementia. However, it has remained unclear whether it is a suitable method to identify mild cognitive impairment (MCI). The aim of this paper is to review systematically the studies concerning the utility of the CDT in diagnosing MCI.Method:A systematic literature search was conducted. All studies dealing with utility of CDT in diagnosing MCI regardless of the applied CDT scoring system and MCI concept were selected.Results:Nine relevant studies were identified. The majority of the studies compared average CDT scores of cognitively healthy and mildly impaired subjects, and four of them identified significant mean differences. If reported, sensitivity and specificity have been mostly unsatisfactory.Conclusion:CDT should not be used for MCI-screening.

Validity and Clinical Utility of Different Clock Drawing Test Scoring Systems in Multiple Forms of Dementia

2018 ◽  
Vol 31 (3) ◽  
pp. 114-122 ◽  
Author(s):  
Diana Duro ◽  
Miguel Tábuas-Pereira ◽  
Sandra Freitas ◽  
Beatriz Santiago ◽  
Maria Amália Botelho ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Lewy Bodies ◽  
Scoring Systems ◽  
Cognitive Screening ◽  
Clock Drawing Test ◽  
Screening Measure ◽  
Clock Drawing ◽  
Drawing Test ◽  
Tertiary Center ◽  
Cognitive Screening Measure

The Clock Drawing Test (CDT) has a known potential for the detection of cognitive impairment in populations with dementia, especially Alzheimer disease (AD). Our aim was to compare the clinical utility of 3 CDT scoring systems (Rouleau, Cahn, and Babins) in several pathologies with cognitive compromise from a tertiary center memory clinic. We selected patients with a clinical diagnosis of mild stage AD, behavioral variant frontotemporal dementia (FTD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and Parkinson disease with dementia (PDD). The results showed significant differences between the several diagnoses with the following pattern of results: AD, DLB < FTD, VaD, PDD. Qualitative analysis of clock drawing errors confirmed the stimulus-bound response as a hallmark of AD, while conceptual deficit was significantly more prevalent in patients with AD and DLB. Our results supported the CDT potential as a cognitive screening measure for mild dementia, particularly sensitive to AD and DLB, especially when we used the Cahn scoring system and its analysis of qualitative errors.

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