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Related Experiment Videos

The clock drawing test and questionable dementia: reliability and validity.

Eva Seigerschmidt1, Edelgard Mösch, Margarete Siemen

  • 1Department of Psychiatry and Psychotherapy of the Technical University of Munich, Germany. seigerschmidt@lrz.tu-muenchen.de

International Journal of Geriatric Psychiatry
|October 31, 2002
PubMed
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The clock drawing test (CDT) shows high reliability but lacks sufficient accuracy for detecting questionable dementia (QD) when used alone. Its scores are also influenced by age, gender, and education.

Area of Science:

  • Gerontology
  • Neuropsychology
  • Cognitive Assessment

Background:

  • The clock drawing test (CDT) is frequently used to screen for cognitive impairment.
  • Its utility in detecting early-stage dementia, specifically questionable dementia (QD), requires further validation.

Purpose of the Study:

  • To evaluate the suitability of the CDT for detecting questionable dementia (QD).
  • To assess inter-rater reliabilities and intercorrelations of four common CDT scoring methods.
  • To determine the concurrent validity of the CDT with other cognitive tests.

Main Methods:

  • 253 non-demented general hospital patients (65-85 years) were assessed 4-6 weeks post-discharge.
  • A cognitive test battery including CDT, Mini-Mental State Examination (MMSE), Syndrome Short Test (SKT), and verbal fluency (VF) was administered.

Related Experiment Videos

  • Clock drawings were scored by two independent raters using four methods; Clinical Dementia Rating (CDR) criteria differentiated between normal cognition and QD.

    • Main Results:

    • High inter-rater reliabilities were found for all four CDT scoring methods.
    • Significant but low correlations were observed between CDT scores and MMSE, SKT, and VF (r = 0.13 to 0.32).
    • CDT sensitivity for QD was 66%, specificity 65%; scores were influenced by age, gender, and education.

    Conclusions:

    • While CDT inter-rater reliability is high, scoring methods are not equivalent, leading to variable abnormal test result proportions.
    • The CDT demonstrates unsatisfactory concurrent validity with other cognitive tests.
    • The CDT lacks sufficient sensitivity and specificity for identifying QD and should not be used as a sole screening tool for prodromal dementia.