The CDT assesses visuospatial and praxis abilities (may reflect both attention and executive dysfunction).
1-2 minutes
Adults
18 - 64
yearsElderly Adult
65 +
yearsClock Drawing Test translations:
French (on p5):
German:
http://web48.s2.webseits.de/images/data/TEST-Teil6-Uhrentest-Sep05.pdf
Spanish:
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Acute Stroke: (Suhr et al, 1998; n = 176 (105 = stroke, 71 community based elderly); mean age of both sample > 70 years; mean time since stroke = 26.13 (9.11) days)
Means and Standard Deviations for 6 Clock Scoring Systems
|
|
Sunderland |
Mendez |
Rouleau |
Watson~ |
Ishiai |
Freedman |
|
Normals |
8.69* (1.9) |
18.33* (1.9) |
8.59* (1.5) |
.83* (1.9) |
3.49* (1.1) |
13.14* (2.5) |
|
Stroke |
5.74 (2.3) |
14.31 (4.4) |
5.91 (2.4) |
4.36 (2.5) |
1.65 (1.5) |
8.67 (4.4) |
|
Right CVA |
5.44 (2.0) |
14.00 (4.1) |
5.54 (2.4) |
4.56 (2.4) |
1.52 (1.4) |
8.24 (4.4) |
|
Left CVA |
6.44 (2.8) |
14.89 (5.0) |
6.61 (2.5) |
4.41 (3.0) |
1.83 (1.6) |
9.61 (4.2) |
|
Bilateral |
6.00 (2.2) |
14.89 (5.0) |
6.56 (2.2) |
3.78 (2.7) |
2.00 (1.4) |
10.11 (3.0) |
|
Anterior |
6.27 (2.4) |
14.47 (4.8) |
6.20 (2.7) |
4.00 (3.0) |
1.73 (1.7) |
9.27 (5.2) |
|
Posterior |
5.67 (2.0) |
14.86 (3.1) |
6.05 (2.1) |
4.48 (2.6) |
1.57 (1.4) |
9.24 (4.0) |
|
Cortical |
5.73 (2.2) |
13.70 (4.3) |
5.61 (2.5) |
4.46 (2.7) |
1.55 (1.5) |
7.82 (4.8) |
|
Subcortical |
5.87 (2.5) |
14.70 (4.9) |
6.20 (2.4) |
4.00 (2.6) |
1.93 (1.4) |
9.23 (4.0) |
|
CVA = Cerebrovascular accident |
|
~For this scoring system, higher numbers mean worse performance. |
|
*p > .001. |
Acute Stroke: (Adunsky et al, 2002; n = 151, mean age = 73.7 (9.9) years, evaluated within 3 days of rehab admission)
Adequate concurrent validity with:
FIM- Cog Domain (r = 0.51)
MMSE (r = 0.59)
Acute Stroke: (N?kleby et al, 2008; n = 49; median age = 62 years; median time since stroke onset 38 days)
|
CDT Sensitivity, specificity and cut scores: |
|
Assessment |
Subtest |
Cut-scores |
Sensitivity (95% CI) |
Specificity (95% CI) |
|
Visuospatia function |
CDT 7 minute |
5/6 |
55 (34–75) |
74 (58–91) |
|
Attention and neglect |
CDT 7 minute |
6/7 |
55 (23–83) |
42 (26–59) |
|
Attention and neglect |
CDT Manos |
9/10 |
55 (23–83) |
49 (31–66) |
|
Attention and neglect |
CDT Sunderland |
9/10 |
55 (23–83) |
42 (26–59) |
|
Speed (non-affected side) |
CDT Sunderland |
9/10 |
74 (56–92) |
59 (39–80) |
|
Impaired > 1 domain |
CDT Sunderland |
9/10 |
63 (49–78) |
67 (22–96) |
Alzheimer Disease: (Tuokko et al, 1992; Mendez et al, 1992)
Alzheimer Disease: (Tuokko et al, 1992; Mendez et al, 1992; Rouleau et al, 1992)
Medical Patients: (Manos & Wu, 1994)
Medical Patients: (Manos & Wu, 1994)
Surgical Patients: (Manos & Wu, 1994)
Surgical and Medical Patients: (Manos & Wu, 1994)
Adunsky, A., Fleissig, Y., et al. (2002). "Clock drawing task, mini-mental state examination and cognitive-functional independence measure: relation to functional outcome of stroke patients." Arch Gerontol Geriatr 35(2): 153-160.
Lorentz, W. J., Scanlan, J. M., et al. (2002). "Brief screening tests for dementia." Can J Psychiatry 47: 723-733.
Manos, P. J. and Wu, R. (1994). "The ten point clock test: a quick screen and grading method for cognitive impairment in medical and surgical patients." Int J Psychiatry Med 24: 229-244.
McDowell, I. (2006). Measuring health: a guide to rating scales and questionnaires, Oxford University Press, USA.
Mendez, M. F., Ala, T., et al. (1992). "Development of scoring criteria for the clock drawing task in Alzheimer's disease." J Am Geriatr Soc 40: 1095-1099.
Nokleby, K., Boland, E., et al. (2008). "Screening for cognitive deficits after stroke: a comparison of three screening tools." Clin Rehabil 22(12): 1095-1104.
Richardson, H. E. and Glass, J. N. (2002). "A comparison of scoring protocols on the Clock Drawing Test in relation to ease of use, diagnostic group, and correlations with Mini-Mental State Examination." J Am Geriatr Soc 50: 169-173.
Rouleau, I., Salmon, D. P., et al. (1992). "Quantitative and qualitative analyses of clock drawings in Alzheimer's and Huntington's disease." Brain Cogn 18(1): 70-87.
Ruchinskas, R. and Curyto, K. (2003). "Cognitive screening in geriatric rehabilitation." Rehabilitation Psychology 48(1): 14-22.
Suhr, J., Grace, J., et al. (1998). "Quantitative and qualitative performance of stroke versus normal elderly on six clock drawing systems." Arch Clin Neuropsychol 13(6): 495-502.
Tuokko, H., Hadjistavropoulos, T., et al. (1992). "The Clock Test: a sensitive measure to differentiate normal elderly from those with Alzheimer disease." J Am Geriatr Soc 40: 579-584.
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.