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.

Cognitive screening instruments to identify vascular cognitive impairment: A systematic review

“…The CDT had moderate to high sensitivity but low specificity in separating VaD from controls, depending on the scoring approach used. The CLOX1 free drawing variant, sensitive to executive control and useful in early impairment, showed the highest accuracy (AUC 0.83) of all CDTs in identifying VaD but even when combined with cube drawing had poor accuracy for VMCI (AUC 0.66), similar to other versions of the CDT . This is in keeping with the finding of a recent systematic review and meta‐analysis, albeit that paper did not specifically examine diagnostic accuracy of CDTs in VCI .…”

Smart Textiles for Improved Quality of Life and Cognitive Assessment

“…Prior to the development of these tools the standard way to evaluate if a person had a cognitive impairment was through observation by clinical staff, interviews with specialists, and observation by family or caregivers [ 67 ]. Other tests exist, including memory-based tasks, such as the clock drawing test, where the individual is asked to draw a clock face with a given time [ 68 ], and the Wisconsin Card Sorting Test [ 69 ]. The use of technology has become more prevalent in the process of administering diagnosis tests to patients, e.g., CogState Brief Battery questions [ 56 ].…”

Teste do Desenho do Relógio: Dados Normativos Para Idosos

“…O TDR é bastante usado durante avaliações neuropsicológicas que visam investigar síndromes demenciais em idosos (Hamdan & Hamdan, 2009;Montiel et al, 2014) por ser considerado como um teste de triagem para o início de uma investigação a respeito de uma doença neuro-degenerativa (Spenciere, Alves, & Charchat-Fichman, 2017;Manso et al, 2018;Rosa, 2016;Aprahamian, Martinelli, Cecato, Izbicki, & Yassuda, 2011;Beber, Kochhann, Matias, & Chaves, 2016). Corroborando essa ideia, estudos epidemiológicos feitos por Nishiwaki et al (2004) apontaram a relevância da utilização do TDR como teste de rastreio para comprometimento cognitivo moderado e severo para idosos.…”

“…Os autores destacam os métodos proposto por Shulman et al (2006), Sunderland et al (1989) e Mendez, Ala e Underwood (1992) como os mais precisos (Spenciere et al, 2017). Assim, a literatura apresenta diversas versões, com formas diferentes de aplicação desse teste, bem como métodos diferentes de escore (Beber et al, 2016), entretanto, no presente artigo, serão usadas as normas definidas por Schulman et al (2006).…”