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Original ArticleOpen Access
Validity of Clinical Use of the Clock-Drawing Test in Thai Elderly Patients with Memory Problems
Jitapunkul S 
,
Worakul P ,
Kiatprakotlz J
,
Worakul P ,
Kiatprakotlz J Forty eight elderly Thai patients, 12 demented, 36 non-demented who consecutively
attended a geriatric clinic, at Chulalongkorn University Hospital, with a memory problem were
recruited in the study which aimed to determine the validity of the clock-drawing test (CDT)
and Chula mental test (CMT). Subjects took the Chula Mental Test (CMT) and were asked to
draw a clock on a preprinted 12 centimeters circle showing the time of II: I 0. Clocks were scored
using the Chula Clock-drawing Scoring System (CCSS). Ten subjects voluntarily participated
and completed the W AIS test. The best cutoff score of the CMT and the CDT using diagnosis of
dementia as a gold standard were 15 and 7 respectively. Sensitivity and specificity for detecting
dementia by the CDT were 100 per cent and 94.1 per cent respectively. Sensitivity and specificity for
detecting dementia by the CMT were 83.3 per cent 91.7 per cent The likelihood ratio (95o/r
confidence interval) of the CMT and the CDT were 10 (3.3-30.4) and 17 (4.4-65.2) respectively.
There was a good correlation of the CDT score and the CMT score with the W AIS score.
Although the CDT was better than the CMT in literate patients, the CDT had limitation of use
among illiterate patients but not the CMT. The benefits of simultaneously application on dementia
screening was shown. This study showed that the CDT was a valuable, brief method of dementia
screening in elderly Thai patients with memory problems.
Key word : Clock-drawing Test, Chula Mental Test, Thai, Elderly, WAIS, Dementia
attended a geriatric clinic, at Chulalongkorn University Hospital, with a memory problem were
recruited in the study which aimed to determine the validity of the clock-drawing test (CDT)
and Chula mental test (CMT). Subjects took the Chula Mental Test (CMT) and were asked to
draw a clock on a preprinted 12 centimeters circle showing the time of II: I 0. Clocks were scored
using the Chula Clock-drawing Scoring System (CCSS). Ten subjects voluntarily participated
and completed the W AIS test. The best cutoff score of the CMT and the CDT using diagnosis of
dementia as a gold standard were 15 and 7 respectively. Sensitivity and specificity for detecting
dementia by the CDT were 100 per cent and 94.1 per cent respectively. Sensitivity and specificity for
detecting dementia by the CMT were 83.3 per cent 91.7 per cent The likelihood ratio (95o/r
confidence interval) of the CMT and the CDT were 10 (3.3-30.4) and 17 (4.4-65.2) respectively.
There was a good correlation of the CDT score and the CMT score with the W AIS score.
Although the CDT was better than the CMT in literate patients, the CDT had limitation of use
among illiterate patients but not the CMT. The benefits of simultaneously application on dementia
screening was shown. This study showed that the CDT was a valuable, brief method of dementia
screening in elderly Thai patients with memory problems.
Key word : Clock-drawing Test, Chula Mental Test, Thai, Elderly, WAIS, Dementia
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