Relationship between clock-drawing and neuropsychological and functional status in elderly institutionalized patients with schizophrenia.
OBJECTIVE
The authors sought to examine the usefulness of the clock-drawing test (CDT) as a measure of general cognitive and adaptive functioning in elderly patients with schizophrenia.


METHODS
CDT performance of elderly institutionalized patients with schizophrenia were contrasted with a comparison group, similar in age. Cognitive and functional status was examined using an expanded battery from the Consortium to Establish a Registry for Alzheimer's disease and the Psychogeriatric Dependency Rating Scale.


RESULTS
Patients (N=21) performed more poorly overall on the CDT than the comparison group (N=21), with greater clock number and hand errors. Production of the clock's gestalt did not differ between groups. In patients, overall CDT performance and clock hand placement were significantly correlated with general cognitive functioning, memory, visuoconstruction, and word-list generation. CDT global and hand placement performances corresponded to patients' general orientation.


CONCLUSIONS
Impaired CDT performance in elderly patients with schizophrenia is not attributable to normal aging. Also, the CDT uniquely relates to an array of cognitive abilities in this population, validating its multicognitive character and implicating multiple brain regions. The CDT's tolerability and brevity make it attractive for use in geriatric schizophrenia.
Lowery
Natasha
N
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. nlowery@bbl.med.upenn.edu
Giovanni
Lauren
L
Mozley
Lyn Harper
LH
Arnold
Steven E
SE
Bilker
Warren B
WB
Gur
Raquel E
RE
Moberg
Paul J
PJ
D000223:Adaptation, Psychological; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015588:Observer Variation; D012559:Schizophrenia / Q000150:complications* / Q000534:rehabilitation*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013998:Time Perception