J Korean Acad Fam Med.  1999 Mar;20(3):269-278.

Comparison of the clock drawing test with the Mini-Mental State Examination as a cognitive screening tool for dlderly patients.

  • 1Department of Family Medicine, College of Medicine, Inga University, Korea.
  • 2Sporex Health Clinic, Pochon Jungmun Medical University, Korea.


BACKGROUND: Cognitive impairment often goes unrecognized by physicians because the many previous tools to evaluate cognitive function in the clinical setting are difficult and time-consuming. The purpose of this study was to compare the Clock Drawing Test(CDT) with the Mini-Mental State Examination (MMSE) as a cognitive screening tool for elderly patients.
In a haspital-based outpatient clinic, 99 patients aged 65 or older were administered with the MMSE and were asked to mark the digits in the pre-drawn clock. They are also evaluated with the Geriatric depression scak, the Activities of Daily Living, and the Instrumental Activities of Daily Living.
Correlation between CDT and MMSE was high (r=-(~0.606; p<0.001). With respect to CDT, there were significant correlations with all subscales of MMSE except registration of memory(p<0.01). CDT with scores of 2 had a sensitivity of 68.2% and a specificity of 70.9% for mild cognitive impairment. CDT with scores of 4 had a sensitivity of 80.8% and a specificity of 84.8% for severe cognitive impairment.
CDT can be an effective and simple cognitive screening tool for the elderly patients in the primary care outpatient clinic, if campensated for registration of memory among the cognitive function.


clock drowning test; dementia; cognitive function; MMSE
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