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Simple scoring of the Clock-Drawing test for dementia screening
Ejnar Alex Kørner1, Lise Lauritzen, Flemming Mørkeberg Nilsson
1Psychogeriatric Outpatient Clinic, Psychiatric Centre North Zealand, Mental Health Service, Capital Region, Denmark. alex.koerner@regionh.dk
Danish Medical Journal
|January 14, 2012
Summary
The Clock-Drawing Test (CDT) shows high predictive values for dementia screening. The shortest scoring method is recommended for its efficiency and comparable results.
Area of Science:
- Neurology
- Geriatrics
- Psychometry
Background:
- The Clock-Drawing Test (CDT) is a widely used tool for cognitive assessment.
- Evaluating different scoring methods is crucial for optimizing its diagnostic utility.
Purpose of the Study:
- To assess the performance of five different scoring methods for the Clock-Drawing Test (CDT).
- To determine the suitability of the CDT as a screening tool for dementia in out-patients.
Main Methods:
- 72 out-patients and 29 healthy controls were assessed thrice.
- The CDT was administered alongside other cognitive tests (MMSE, GDS, CGI).
- Receiver-operating characteristics (ROC) curve analyses were employed to evaluate screening performance.
Main Results:
- All five CDT scoring methods demonstrated good correlations with other cognitive scales.
- High predictive values were observed (positive: 93-97%; negative: 70-74%).
- Incorporating three-word recall improved predictive values; however, lower dementia prevalence significantly reduced positive predictive values.
Conclusions:
- The predictive accuracy of the evaluated CDT scoring methods was nearly identical.
- The simplest scoring manual (0 to 1) is recommended for practical application due to its efficiency.
