The Mini-Cog test combines a clock-drawing test with tests of recall to provide a brief screening tool suitable for primary care patients, even those who do not speak English as their native language. Steven McGee MD, in Evidence-Based Physical Diagnosis (Third Edition), 2012 III Mini-Cog Test A Technique and Scoring Presently, CDT and MMSE have been evaluated in combination as a way to improve detection of MCI cases ( Cacho et al., 2010). It is also very useful for testing subjects across education levels and cultures ( Ainslie and Murden, 1993). It is useful for identifying moderate and severe AD patients, but has limitations for diagnosing MCI and early stage AD. CDT is a quick, simple, and cost-effective tool for assessing dementia in a primary care setting. The scoring depends on how the clock was drawn with appropriate markings of an analog clock: 12 numbers, correctly positioned hour-hand and minute-hand, etc. The grading system is very simple and is scaled to 10 points. In the original testing method, a predrawn clock is given to the subject, who is asked to draw the clock hands indicating 10 min past 11 o’clock. Evidence suggests that it was first used by the British neurologist/psychiatrist Sir Henry Head. The test includes questions in a number of areas including attention, calculation, comprehension, construction, naming, orientation, recall, registration, repetition, spelling, and writing. Khan PhD, in Biomarkers in Alzheimer's Disease, 2016 2.2.2 Clock Drawing TestĪfter the MMSE, clock drawing test (CDT) is the second most widely used test for grading cognitive states. We have used and validated a relatively straightforward system that is easy to administer and accurate (see Appendix A for details). There are many versions of the Clock Drawing Test, in terms of both administration procedures and scoring. Many of our patients have difficulty with analog watches in the early stages of a dementing illness (we often address this problem by suggesting they wear a digital watch). This single test may be sensitive to dementia because it involves many cognitive areas that can be affected by dementia, including executive function, visuospatial abilities, motor programming, and attention and concentration. Although there are multiple versions of this test, in general, they all ask the patient to draw the face of a clock and then to draw the hands to indicate a particular time. The clock drawing test (CDT) is a rapidly administered test that is appropriate for primary care practices. Solomon Ph.D., in Memory Loss, Alzheimer's Disease, and Dementia (Second Edition), 2016 Clock Drawing Test 55 If the patient is unable to recall all three words in the Mini-Cog, he or she is considered to have a cognitive impairment.Īndrew E. It was developed to improve the relatively culture-free CDT by assessing the patient’s recall (memory) and thereby covering the domains of the MMSE. The Mini-Cog, in which a three-word recall test is added to the CDT, has the advantage of also assessing memory. This may be because of the instability and subtle nature of cognitive impairment in patients with heart failure, in contrast to patients with dementia. Riegel and colleagues 18 concluded that the CDT was better than the MMSE at detecting cognitive impairment in patients with heart failure. 58 Advantages of this test include an absence of language and cultural biases. 18,58 There are multiple approaches to scoring the CDT. 47 The patient is then asked to draw the hands on the clock to indicate “ten minutes past 11 o’clock.” The test also assesses long-term attention, memory, auditory processing, motor programming, and frustration tolerance. Placement of the numbers around the circle requires visual-spatial, numerical sequencing, and planning abilities. The Clock Drawing Test (CDT) is a nonverbal screening tool in which the patient is asked to draw a clock. Varda Konstam, Ilana Lehmann, in Heart Failure: A Companion to Braunwald's Heart Disease (Second Edition), 2011 Clock Drawing Test and the Mini-Cog
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