Qualitative analysis and identification of pattern of errors in Clock Drawing Tests of community-dwelling older adults

Abstract The Clock Drawing Test (CDT) is a frequently employed screening tool with different scoring systems. Quantitative and semi-quantitative scoring systems, such as Sunderland’s et al. (1989), do not discriminate different error patterns. Thus, the same score can represent a number of different neuropsychological profiles. Therefore, the use of a scoring method that emphasizes qualitative aspects to determine specific error patterns is fundamental. Objective: To use a qualitative scale to analyze error patterns in the CDTs of older adults who scored 5 in a previous study. Methods: 49 CDTs with score of 5 were analyzed using the qualitative scale. Linear regression and hierarchical and non-hierarchical cluster analyses were performed. Results: The linear regression showed a significant association between the total score and all the error patterns of the qualitative scale. The hierarchical cluster yielded three groups. However, due to the heterogeneity observed among the groups, a non-hierarchical cluster analysis was performed to better understand the results. Three groups were determined with different neuropsychological profiles and patterns of errors. Conclusion: The qualitative scoring of the CDT is important when examining and analyzing specific neuropsychological domains in older adults, especially executive functions.