Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Jan-Mar;11(1):6-14.
doi: 10.1590/1980-57642016dn11-010003.

Scoring systems for the Clock Drawing Test: A historical review

Bárbara Spenciere  1 , Heloisa Alves  2 , Helenice Charchat-Fichman  2
Affiliations
Review

Scoring systems for the Clock Drawing Test: A historical review

Bárbara Spenciere et al. Dement Neuropsychol. 2017 Jan-Mar.

Abstract
in English, Portuguese

The Clock Drawing Test (CDT) is a simple neuropsychological screening instrument that is well accepted by patients and has solid psychometric properties. Several different CDT scoring methods have been developed, but no consensus has been reached regarding which scoring method is the most accurate. This article reviews the literature on these scoring systems and the changes they have undergone over the years. Historically, different types of scoring systems emerged. Initially, the focus was on screening for dementia, and the methods were both quantitative and semi-quantitative. Later, the need for an early diagnosis called for a scoring system that can detect subtle errors, especially those related to executive function. Therefore, qualitative analyses began to be used for both differential and early diagnoses of dementia. A widely used qualitative method was proposed by Rouleau et al. (1992). Tracing the historical path of these scoring methods is important for developing additional scoring systems and furthering dementia prevention research.

O Teste do Desenho do Relógio (TDR) é um instrumento de rastreio neuropsicológico simples bem aceito pelos pacientes e com sólidas propriedades psicométricas. Em meio aos métodos de pontuação, não existe consenso com relação aos que tenham maior acurácia. Esse artigo tem como objetivo realizar uma revisão histórica sobre os sistemas de pontuação mais utilizados e as mudanças ocorridas com os mesmos ao longo dos anos. No decorrer do caminho histórico, diferentes tipos de sistemas de pontuação surgiram. Inicialmente, o foco era no rastreio de demência e os métodos utilizados eram quantitativos e semi-quantitativos. Contudo, em um segundo momento, a necessidade de diagnóstico precoce demandou o uso de um sistema de pontuação que pudesse especificar erros sutis especialmente aqueles relacionados a funções executivas. Assim, análise qualitativa começou a ser mais usada em ambos no diagnóstico diferencial e precoce de demência. Um método qualitativo amplamente utilizado é o de Rouleau et al. (1992). O caminho histórico é importante para o desenvolvimento dos sistemas de pontuação e também para as pesquisas de prevenção de demência.

Keywords: Clock Drawing Test; neuropsychology; scoring; screening test.

PubMed Disclaimer

Conflict of interest statement

Disclosure: The authors report no conflicts of interest

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Mendez MF, Ala T, Underwood KL. Development of scoring criteria for the clock drawing task in Alzheimer' disease. J Am Geriatr Soc. 1992;40:1095–1099. - PubMed
    1. Strauss E, Sherman EMS, Spreen O. A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary ( 3rd ed. New York: Oxford University Press; 2006.
    1. Fuzikawa C, Lima-Costa MF, Uchoa E, Barreto SM, Shulman KI. A population based study on the intra and inter-rater reliability of the clock drawing test in Brazil the Bambuí Health and Ageing Study. Int J Geriatr Psychiatry. 2003;18:450–456. - PubMed
    1. García-Caballero A, Recimil MJ, García-Lado I, Gayoso P, Cadarso-Suarez C, Gonzalez-Hermida J, et al. ACE clock scoring a comparison with eight standard correction methods in a population of low educational level. J Geriatr Psychiatry Neurol. 2006;19:216–219. - PubMed
    1. Hubbard EJ, Santini V, Blankevoort CG, Volkers KM, Barrup MS, Byerly L, et al. Clock drawing performance in cognitively normal elderly. Arch Clin Neuropsychol. 2008;23:295–327. - PMC - PubMed