Cultural influence on clock drawing test: A systematic review

Area of Science:

• Neuropsychology
• Cross-cultural psychology

Background:

• Dementia in migrant populations is a growing global concern.
• Neuropsychological tests need cultural sensitivity for accurate cognitive decline assessment.
• The Clock Drawing Test (CDT) is a common screening tool, but its cross-cultural validity is debated.

Approach:

• A systematic literature review was conducted across three databases.
• Studies examined the influence of language, education, literacy, acculturation, and ethnicity on CDT performance.
• 105 studies comprising 160 analyses were included.

Key Points:

• Cultural determinants significantly impact CDT performance (79.4% of analyses).
• Higher education (76.6%) and better education quality positively affected scores.
• Illiteracy negatively impacted CDT performance in most studies (90%).
• Ethnicity yielded conflicting results; acculturation showed mixed effects.
• Language had minimal influence (12.5% of analyses).

Conclusions:

• The CDT's utility in multicultural contexts requires careful consideration.
• Despite limited linguistic demands, cultural factors can affect CDT results.
• Further research into culturally adapted scoring systems is warranted.