title: The Reliability of Clock Drawing Test Scoring Systems Modeled on the Normative Data in Healthy Aging and Nonamnestic Mild Cognitive Impairment.
abstract: The Clock Drawing Test (CDT) is a commonly used tool in clinical practice and research for cognitive screening among older adults. The main goal of the present study was to analyze the interrater reliability of three different CDT scoring systems (by Shulman et al., Babins et al., and Cohen et al.). We used a clock with a predrawn circle. The CDT was evaluated by three independent raters based on the normative data set of healthy older and very old adults and patients with nonamnestic mild cognitive impairment (naMCI; N = 438; aged 61-94). We confirmed a high interrater reliability measured by the intraclass correlation coefficients (ICCs): Shulman ICC = .809, Babins ICC = .894, and Cohen ICC = .862, all p < .001. We found that age and education levels have a significant effect on CDT performance, yet there was no influence of gender. Finally, the scoring systems differentiated between naMCI and age- and education-matched controls: Shulman's area under the receiver operating characteristic curve (AUC) = .84, Cohen AUC = .71, all p < .001; and a slightly lower discriminative ability was shown by Babins: AUC = .65, p = .012.
authors.affiliation: 1 Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic.|2 International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
authors.forename: Adela Fendrych
authors.initials: AF
authors.lastname: Mazancova
authors.affiliation: 1 Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic.|2 International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
authors.forename: Tomas
authors.initials: T
authors.lastname: Nikolai
authors.affiliation: 3 National Institute of Mental Health, Klecany, Czech Republic.
authors.forename: Hana
authors.initials: H
authors.lastname: Stepankova
authors.affiliation: 3 National Institute of Mental Health, Klecany, Czech Republic.
authors.forename: Miloslav
authors.initials: M
authors.lastname: Kopecek
authors.affiliation: 1 Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic.|3 National Institute of Mental Health, Klecany, Czech Republic.
authors.forename: Ondrej
authors.initials: O
authors.lastname: Bezdicek
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D018153:Czech Republic; D005260:Female; D000073656:Healthy Aging / Q000523:psychology*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards*; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric
keywords: Clock Drawing Test; cognitive screening; mild cognitive impairment; normative data; reliability; scoring systems