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The Clock Drawing Test: Diagnostic, Functional, and Neuroimaging Correlates in Older Medically Ill Adults

Received October 28, 2003; revised May 3, 2004; accepted May 7, 2004. From the New York-Presbyterian Hospital-Weill Medical College of Cornell University, Department of Psychiatry, New York, New, York. Address correspondence to Dr. Ferrando, Director, Division of Psychosomatic Medicine, NY-Presbyterian Hospital, East 68th St., Box 181, NY, NY 10021; sjferran{at}med.cornell.edu (E-mail).

This study evaluated the clock drawing test (CDT), a screening test sensitive to executive function, in 70 elderly psychiatric consultation patients. The CDT was compared to the Mini-Mental Status Examination (MMSE) on associations with psychiatric diagnoses, disposition status and radiographic findings. CDT and MMSE were correlated, and scores differed across psychiatric subgroups. In multivariate analysis, only age and CDT predicted disposition status. A lower CDT score correlated with a higher intercaudate ratio, indicating greater caudate atrophy. These findings suggest that the CDT indicates underlying subcortical pathology and deficiencies in executive function important for self-care.

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