Validity and Clinical Utility of Different Clock Drawing Test Scoring Systems in Multiple Forms of Dementia

Diana Duro, Miguel Tábuas-Pereira, Sandra Freitas, Beatriz Santiago, Maria Amália Botelho, Isabel Santana

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


The Clock Drawing Test (CDT) has a known potential for the detection of cognitive impairment in populations with dementia, especially Alzheimer disease (AD). Our aim was to compare the clinical utility of 3 CDT scoring systems (Rouleau, Cahn, and Babins) in several pathologies with cognitive compromise from a tertiary center memory clinic. We selected patients with a clinical diagnosis of mild stage AD, behavioral variant frontotemporal dementia (FTD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and Parkinson disease with dementia (PDD). The results showed significant differences between the several diagnoses with the following pattern of results: AD, DLB < FTD, VaD, PDD. Qualitative analysis of clock drawing errors confirmed the stimulus-bound response as a hallmark of AD, while conceptual deficit was significantly more prevalent in patients with AD and DLB. Our results supported the CDT potential as a cognitive screening measure for mild dementia, particularly sensitive to AD and DLB, especially when we used the Cahn scoring system and its analysis of qualitative errors.

Original languageEnglish
Pages (from-to)114-122
JournalJournal of geriatric psychiatry and neurology
Issue number3
Early online date9 May 2018
Publication statusPublished - May 2018


  • cognitive screening
  • dementia
  • neuropsychological tests
  • validation


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