BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet Test: Clock-drawing Test Year: 1986 Domain: Psychological Assessment Tool Category: Dementia/Alzheimer's Variations/Translations: N/A Setting: Clinical Method of Delivery: Assessment by clinician Description: This test has been used as a test of cognitive function and has been proposed as a screening test for dementia. Can indicate constructional apraxia, left unilateral spatial neglect, conceptual difficulties and a disturbance of visuospatial skills (shown to be an early sign of dementia). The task may take the form of clock drawing, clock setting or clock reading. Offers a rapid screeming method . Should be applicable across most cultures and language groups. Unlikely to suffice as a screen for dementia, should be used to supplement other methods. Scoring/Interpretation: Scoring varies in different studies. Scores usually evaluate omissions of numbers, errors in placing numbers, rotations, perseverations, switching numbers, and the spacing between the numbers. A higher score indicates a higher level of impairment. Time to Administer: N/A Availability: Online version available for fee on website Software: N/A Website: http://www.clockdrawingtest.com/index_files/clockdrawingtest.htm Quantitative/Qualitative: Quantitative Validity (Quantitative): Sensitivity to dementia across many studies range from 75 to 92 percent depending on the population being assessed and averaged 85%. Specificity ranged from 65 to 96 percent with an average of 85%, however clock errors may predict many conditions in addition to dementia and it is important to maintain a wide differential diagnosis with clock errors. Its scores are often correlated to other measures such as the MMSE, Global Deterioration Score and Dementia Rating Scale. Reliability (Quantitative): Inter-rater reliability ranges from 0.85 to 0.95 References: Ganguli, M., Ratcliff, G., Huff, F.J. et al. (1991). Effects of age, gender, and education on cognitive tests in a rural elderly community sample: norms from the Monongahela Valley Independent Elders Survey. Neuroepidemiology, 10: 42-52. Ishiai, S., Sugishita, M., Ichikawa, T., et al. (1993). Clock-drawing test and unilateral spatial neglect. Neurology, 43: 106-110. Mendez, M.F., Ala, T., & Underwood, K.L. (1992). Development of scoring criteria for the clock drawing task in Alzheimer’s disease. JAGS, 40: 1095-1099. Rouleau, I., Salmon, D.P., Butters, N., et al. (1992). Quantitative and qualitative analyses of clock drawings in Alzheimer’s and Huntington’s disease. Brain Cognition, 18: 70-87. Shulman, K.I., Gold, D.P., Cohen, C.A., & Zucchero, C.A. (1993) Clock-drawing and dementia in the community: A longitudinal study. International Journal of Geriatric Psychology, 8:487-96. Sunderland, T., Hill, J.L., Mellow, A.M., et al. (1989). Clock drawing in Alzheimer’s disease: a novel measure of dementia severity. JAGS, 37: 725-729. Tuokko, H., Hadjistavropoulos, T., Miller, J.A., et al. (1992). The clock test: a sensitive measure to differentiate normal elderly from those with Alzheimer disease. JAGS, 40: 579-584. Watson, Y.I., Arfken, C.L., Birge, S.J. (1993). Clock completion: an objective screening test for dementia. JAGS, 41: 1235-1240. Wolf-Klein, G.P., Silverstone, F.A., Levy, A.P., et al. (1989).Screening for Alzheimer’s disease by clock drawing. JAGS, 37: 730-734 Comments: N/A