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Dementia & Neuropsychologia

Print version ISSN 1980-5764

Dement. neuropsychol. vol.3 no.2 São Paulo Apr./June 2009 

Original Articles

The Clock Drawing Test A review of its accuracy in screening for dementia

O Teste do Desenho do Relógio: revisão da acurácia no rastreamento de demência

Ivan Aprahamian1 

José Eduardo Martinelli2 

Anita Liberalesso Neri3 

Mônica Sanches Yassuda4 

1MD, MSc, Psychogeriatric Unit, Laboratory of Neuroscience (LIM 27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, SP, Brazil. Gerontology Division, University of Campinas.

2MD, MSc, PhD, Assistant Professor, Geriatrics Division, Jundiaí Medical School, Jundiaí, SP, Brazil.

3PhD, Professor, Gerontology, Medical Sciences Faculty, UNICAMP, São Paulo, SP, Brazil.

4PhD, Assistant Professor of Gerontology, School of Arts, Sciences and Humanities (EACH), University of São Paulo. Psychogeriatric Unit, Laboratory of Neuroscience (LIM 27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.


The Clock Drawing Test (CDT) is a simple neuropsychometric instrument that can be easily applied to assess several cognitive functions. Over the past 20 years, the CDT has aroused considerable interest in its role for the early screening of cognitive impairment, especially in dementia. Although the CDT is considered an accurate test for dementia screening, recent studies including comparisons with structured batteries such as the CAMCOG have shown mixed results.


To investigate the importance of the CDT compared to other commonly used tests, in the diagnosis of dementia in the elderly; (2) to evaluate the reliability and correlation between available CDT scoring scales from recent studies.


A systematic search in the literature was conducted in September 2008 for studies comparing CDT scoring systems and comparing the CDT with neuropsychiatric batteries.


Twelve studies were selected for analyses. Seven of these studies compared CDT scoring scales while five compared the CDT against the CAMCOG and the MMSE. Eight studies found good correlation and reliability between the scales and the other tests.


Despite the mixed results in these studies, the CDT appears to be a good screening test for dementia.

Key words: clock drawing test; dementia; elderly.


O Teste do Desenho do Relógio (TDR) é um instrumento neuropsiquiátrico simples que pode ser aplicado facilmente para avaliar diversas funções cognitivas. Nos últimos 20 anos, o TDR tem despertado interesse considerável sobre seu papel no rastreio precoce de declínio cognitivo, especialmente na demência. Apesar do TDR ser considerado um bom teste para o rastreio da demência, estudos recentes com comparações com baterias neuropsiquiátricas como o CAMCOG mostram resultados variados.


Investigar a importância do TDR quando comparado com outros testes comumente utilizados no diagnóstico de demência; avaliar a confiabilidade e a correlação entre escalas de pontuação do TDR em estudos recentes.


Uma busca sistemática na literatura foi concluída em setembro de 2008, incluindo estudos que compararam sistemas de pontuação de TDR e que compararam o TDR com baterias neuropsicométricas.


Doze estudos foram selecionados para análise. Sete compararam escalas de pontuação de TDR e cinco compararam o TDR com o CAMCOG e o MEEM. Oito estudos encontraram boa correlação e confiabilidade entre as escalas e outros testes.


Apesar dos resultados variados nesses estudos, o TDR parece ser um bom teste de rastreio cognitivo para demência.

Palavras-chave: teste do desenho do relógio; demência; idosos.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.


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Received: February 16, 2009; Accepted: May 18, 2009

Ivan Aprahamian - Laboratório de Neurociência (LIM 27) / Departamento e Instituto de Psiquiatria HC FMUSP - Rua Dr. Ovídio Pires de Campos, 785 / 3o. andar - 05403-010 São Paulo SP - Brazil. E-mail:

Disclosure: The authors report no conflicts of interest.

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