The Performance of the Clock Drawing Test in Elderly Medical Inpatients: Does It Have Utility in the Identification of Delirium?

• Published in: Journal of geriatric psychiatry and neurology Vol. 18; no. 3; pp. 129 - 133
• Main Authors: Adamis, Dimitrios, Morrison, Catriona, Treloar, Adrian, Macdonald, Alastair J. D., Martin, Finbarr C.
• Format: Journal Article
• Language: English
• Published: Thousand Oaks, CA Sage Publications 01-09-2005; Decker; Sage Publications, Inc
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Care and treatment; Cognition Disorders - diagnosis; Cognition Disorders - epidemiology; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Delirium; Delirium - diagnosis; Delirium - epidemiology; Diagnosis; Female; Geriatrics; Health aspects; Humans; Male; Medical sciences; Medical screening; Methods; Neurology; Neuropsychological Tests; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychometrics; Psychopathology. Psychiatry; Risk factors; Severity of Illness Index; United States; psychometrics; Clock Drawing Test (CDT); elderly; delirium; Human; Delirium; Performance evaluation; Neuropsychological test; Psychometrics; Hospitalization; Identification; Organic mental disorder; Medicine; Gerontology; Hospital; Performance; Elderly; Mental confusion; Geriatrics
• ISSN: 0891-9887; 1552-5708
• DOI: 10.1177/0891988705277535

The Clock Drawing Test is an often-used test for the detection of cognitive impairment, but the few studies that have evaluated its utility in delirium have produced rather inconsistent results. In a longitudinal study of delirium in elderly medical inpatients, we have investigated the relationships between the Clock Drawing Test, the presence and severity of delirium, and cognitive impairment. Using mixed linear model analysis we found that cognitive impairment was the major factor associated with low Clock Drawing Test scores (P < .0001): neither the presence nor the severity of delirium had additional significant effect on the Clock Drawing Test. Thus, we conclude that although the Clock Drawing Test is a good detector of cognitive impairment, it is not a suitable tool for detection of delirium in elderly medical inpatients.