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J Am Geriatr Soc. 1992 Nov;40(11):1095-9.

Development of scoring criteria for the clock drawing task in Alzheimer's disease.

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Department of Neurology, St. Paul-Ramsey Medical Center/University of Minnesota, St. Paul 55101.



To investigate the reliability and validity of free-hand clock drawings, a frequently used measure of constructional apraxia, in patients with Alzheimer's disease.


Survey for the purpose of testing reliability and validity of a new scale.


Memory Disorder Clinic at a university-affiliated hospital in the Upper Midwest.


Forty-six patients were diagnosed with clinically probable dementia of the Alzheimer type after a dementia evaluation, and 26 normal elderly controls were research volunteers without a history of cognitive dysfunction.


Neuropsychological tests, dementia-related scales, and clock drawings rated by a new 20-item Clock Drawing Interpretation Scale. Reliability measures, correlations, and clustering of items in the CDIS.


The CDIS had inter-rater reliability (r = .94), internal consistence (rtt = .95), and reproducibility over a 6-month interval. CDIS scores were significantly correlated with two dementia-related scales and all neuropsychological tests and had the highest correlations with other measures of constructional apraxia. All but four Alzheimer patients (91%) and none of the controls had CDIS scores of 18 or less.


Clinicians may reliably screen patients with Alzheimer's disease with the clock-drawing task, a measure sensitive to deficits in constructional apraxia.

[Indexed for MEDLINE]

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