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Can clock drawing differentiate Alzheimer's disease from other dementias?

Published online by Cambridge University Press:  03 July 2015

Lynnette Pei Lin Tan ,
Nathan Herrmann ,
Brian J. Mainland  and
Kenneth Shulman
Lynnette Pei Lin Tan*
Affiliation:
Department of Psychiatry, Sunnybrook Health Sciences Centre, Canada; Department of Psychological Medicine, Tan Tock Seng Hospital, Singapore
Nathan Herrmann
Affiliation:
Division of Geriatric Psychiatry, Department of Psychiatry, Sunnybrook Health Sciences Centre, Canada; Department of Psychiatry, University of Toronto, Canada
Brian J. Mainland
Affiliation:
Department of Psychology, Ryerson University, Toronto, Canada
Kenneth Shulman
Affiliation:
Sunnybrook Health Sciences Centre, Canada; Department of Psychiatry, University of Toronto, Canada
*
Correspondence should be addressed to: Lynnette Pei Lin Tan, Psychological Medicine Department, Tan Tock Seng Hospital, Annex Building Level 3, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore. Phone: +65 63577841; Fax: +65 63573088. Email: lynnette_tan@ttsh.com.sg.
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Abstract

Background:

Studies have shown the clock-drawing test (CDT) to be a useful screening test that differentiates between normal, elderly populations, and those diagnosed with dementia. However, the results of studies which have looked at the utility of the CDT to help differentiate Alzheimer's disease (AD) from other dementias have been conflicting. The purpose of this study was to explore the utility of the CDT in discriminating between patients with AD and other types of dementia.

Methods:

A review was conducted using MEDLINE, PsycINFO, and Embase. Search terms included clock drawing or CLOX and dementia or Parkinson's Disease or AD or dementia with Lewy bodies (DLB) or vascular dementia (VaD).

Results:

Twenty studies were included. In most of the studies, no significant differences were found in quantitative CDT scores between AD and VaD, DLB, and Parkinson's disease dementia (PDD) patients. However, frontotemporal dementia (FTD) patients consistently scored higher on the CDT than AD patients. Qualitative analyses of errors differentiated AD from other types of dementia.

Conclusions:

Overall, the CDT score may be useful in distinguishing between AD and FTD patients, but shows limited value in differentiating between AD and VaD, DLB, and PDD. Qualitative analysis of the type of CDT errors may be a useful adjunct in the differential diagnosis of the types of dementias.

Keywords

clock-drawing testAlzheimer’s diseasevascular dementiaParkinson’s dementiadementia with Lewy bodiesfrontotemporal dementia
Type
Review Article
Information
International Psychogeriatrics , Volume 27 , Special Issue 10: Psychosocial and Ethical Aspects of Dementia , October 2015 , pp. 1649 - 1660
Copyright
Copyright © International Psychogeriatric Association 2015 

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