53 PCN Function Assessment CDT

Clock-Drawing Test

  • Step 1
    • give patient a sheet of paper with a drawn large circle
  • Step 2
    • instruct to draw numbers in the circle to look like the face of a clock; then draw the hands of the clock to read “10 after 11”

Scoring:

Points General Description Specific Description
1 perfect no errors
2 minor visual-spatial errors
  • mildy impaired spacing of numbers
  • draws numbers outside of circle
  • turns page > draws numbers upside down
  • draws with lines (“spokes”)
3 inaccurate representation of 10 after 11 when visual-spatial organization is perfect or minor deviation
  • minute hand points to 10
  • writes “10 after 11”
  • unable to make any notation of time
4 moderate visual-spatial disorganization of times such that accurate notation of 10 after 11 not identified
  • moderately poor spacing
  • omits numbers
  • perseveration
  • counterclockwise
  • dysgraphia
5 severe level of disorganization as in 4
6 no reasonable representation of a clock
  • no attempt
  • no semblance of a clock
  • writes a word or name
  • (3 or greater = cognitive deficit)
  • High NEGATIVE predictive value (95%) > normal CDT strong argument against cognitive deficit
  • Requires comprehension, visual-spatial ability, reconstruction skills, concentration, numerical knowledge, visual memory, executive function; not biased by age, gender; not influenced by language limitation or altered mood

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Reference Notes for Palliative Care Consultation Copyright © 2018 by Robert F. Johnson MD, MEd is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

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