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Free keywords:
Clock Drawing Test; Scoring system; Dementia; MCI
Abstract:
Background: There is a strong demand for screening instruments for mild cognitive impairment (MCI), as a
pre-stage of dementia. The clock drawing test (CDT) is widely used to screen for dementia, but the utility
in screening for MCI remains uncertain. In particular, it is still questionable which scoring system is the best
in order to screen for MCI. We therefore aimed to compare the utility of different CDT scoring systems for
screening for MCI.
Methods: In a sample of 428 subjects of the Leipzig Longitudinal Study of the Aged (LEILA 75+) study, CDT
scores of different scoring systems were compared between subjects with and without MCI. Comparison of
receiver operating characteristic (ROC; area under the curve, sensitivity, specificity) was performed and
inter-rater reliability was calculated.
Results: The CDT scores differed significantly between MCI and non-MCI subjects according to all scoring
systems applied. However, ROC of the CDT scores was not adequate.
Conclusions: None of the present CDT scoring systems has sufficient utility to screen reliably for MCI. The
clinical value of the CDT could be improved by using semi-quantitative scoring, having a wider score range
and focusing on specific details of the clock (e.g. the hands and numbers).
