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

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.

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

International Psychogeriatrics ◽

10.1017/s1041610209990676 ◽

2009 ◽

Vol 22 (1) ◽

pp. 56-63 ◽

Cited By ~ 44

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.

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Usefulness of the Clock Drawing Test as a Cognitive Screening Instrument for Mild Cognitive Impairment and Mild Dementia: an Evaluation Using Three Scoring Systems

Dementia and Neurocognitive Disorders ◽

10.12779/dnd.2018.17.3.100 ◽

2018 ◽

Vol 17 (3) ◽

pp. 100 ◽

Cited By ~ 6

Author(s):

Sangsoon Kim ◽

Seungmin Jahng ◽

Kyung-Ho Yu ◽

Byung-Chul Lee ◽

Yeonwook Kang

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Scoring Systems ◽

Screening Instrument ◽

Cognitive Screening ◽

Mild Dementia ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test

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

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130118 ◽

2013 ◽

Vol 71 (10) ◽

pp. 763-768 ◽

Cited By ~ 19

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.

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