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Specific algorithm method of scoring the Clock Drawing Test applied in cognitively normal elderly.

Liana Chaves Mendes-Santos1, Daniel Mograbi1,2, Bárbara Spenciere3

  • 1PhD, Department of Psychology, Pontifical Catholic University of Rio de Janeiro RJ, Brazil.

Dementia & Neuropsychologia
|December 8, 2017
PubMed
Summary

The Clock Drawing Test (CDT) shows high inter-rater reliability when scored with a specific algorithm in cognitively normal elderly. A frequent score of 5 suggests a need for more sensitive evaluation criteria for aging cognitive abilities.

Keywords:
Clock Drawing Testelderlyinter-rater reliabilityneuropsychology

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Area of Science:

  • Gerontology
  • Neuropsychology
  • Cognitive Assessment

Background:

  • The Clock Drawing Test (CDT) is a widely used, cost-effective tool for assessing cognitive function, particularly in older adults.
  • It serves as a screening instrument for cognitive disorders and dementia, though scoring methods can vary.
  • Understanding performance and reliability is crucial for accurate clinical application.

Purpose of the Study:

  • To analyze the performance of elderly individuals on the Clock Drawing Test (CDT).
  • To evaluate the inter-rater reliability of the CDT when scored using a specific algorithm adapted from Sunderland et al. (1989).

Main Methods:

  • 100 cognitively normal elderly participants (aged 60+) underwent the free-drawn CDT and Mini-Mental State Examination (MMSE).
  • Six independent examiners scored the CDT for 30 participants to assess inter-rater reliability.
  • A specific algorithm, adapted from Sunderland et al., was used for scoring.

Main Results:

  • A score of 5 (equivalent to 5 points on the Sunderland scale) was the most frequent outcome (53.5%) using the proposed algorithm.
  • The CDT scoring algorithm demonstrated high inter-rater reliability (p<0.01).
  • Mean scores ranged from 5.06 to 5.96.

Conclusions:

  • The specific algorithm for scoring the CDT exhibits high inter-rater reliability in cognitively normal elderly individuals.
  • The frequent occurrence of a score of 5 suggests potential limitations in current criteria for detecting subtle age-related changes.
  • Further development of nuanced evaluation criteria is recommended to better assess visuoconstructive and executive function declines during aging.