Correlation and agreement between the Mini-mental State Examination and the Clock Drawing Test in older adults with low levels of schooling: the Bambuí Health Aging Study (BHAS)

Abstract

Correlation between tests was moderate. Subjects who performed well on the CDT could be expected to obtain high MMSE scores. Although one test does not substitute for the other, the CDT may be more practical in developing countries where resources are limited and low education is common in the elderly, as well as in situations where time for assessment or screening is limited. Moreover, the CDT may be sensitive to cognitive domains not assessed by the MMSE.

The Clock Drawing Test: performance among elderly with low educational level

“…Similarly, the results of Fuzikawa et al 24 suggest that there is a good correlation between the CDT and other cognitive tests (i.e., MMSE), even in illiterate elderly with low educational level. This is likely due to some degree of parallelism between these tools, in that they are probably measuring aspects of related cognitive constructs, but it does not necessarily follow that these tests have good accuracy.…”

“…24 The neuropsychometric tests included the cognitive part of the Cambridge Examination for Mental Disorders of the Elderly -Revised (CAMDEX-R), 31 the CAMCOG-R. This is a concise neuropsychological test battery for the assessment of cognitive impairment in elderly people, and examines a broad range of cognitive functions, such as memory, language, attention, perception, and executive functions.…”

“…[15][16][17][18][19][20][21] In Brazil, however, only Okamoto 22 and Fuzikawa et al 23,24 have produced the few studies published about this instrument. Okamoto 22 studied spontaneous clock drawings, ability to tell time, placement of the hour hand, and copies of clock drawings in 50 patients with Alzheimer's dementia (DAT), nine with Lewy body dementia (DLB), six with mild cognitive impairment (MCI), and 43 from a control group.…”

“…Fuzikawa et al 24 evaluated a sample of 1,118 elderly subjects from a population-based cohort study to determine the correlation and agreement between the MMSE 25 and CDT. Correlation between tests was moderate.…”

“…Despite the importance of these papers in exploring the first data about CDT performance in Brazilian people, the high schooling of the sample in the first study 22 and the absence of a confirmatory standard in the last two 23,24 limited our ability to conclude that the CDT is a useful tool to screen elderly individuals with low educational level for dementia.…”