Clock Drawing in Alzheimer's Disease: A Novel Measure of Dementia Severity

Trey Sunderland*, James L. Hill, Alan M. Mellow, Brian A. Lawlor, Joshua Gundersheimer, Paul A. Newhouse, Jordan H. Grafman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

857 Scopus citations


We have tested a simple and reliable measure of visuospatial ability in Alzheimer patients — the Clock Drawing Test. To determine the usefulness of this measure, we asked 67 Alzheimer patients and 83 normal controls to draw the face of a clock reading the time of 2:45. Six independent observers blindly evaluated the results with ratings from 10 (best) to 1 (worst). The mean performance score of Alzheimer subjects was 4.9 ± 2.7 compared to 8.7 ± 1.1 for normal controls (P < .001). Inter‐rater reliability for the clocks drawn by Alzheimer patients was highly significant (r = 0.86; P < .001), and there was relatively little overlap between ratings for Alzheimer patients and normal controls. Furthermore, correlations were highly significant (P < .001) between the mean score of clock drawings and three independent global measures of dementia severity. Although the Clock Drawing Test is certainly not a definitive indicator of Alzheimer's disease, the test is easy to administer and provides a useful measure of dementia severity for both research and office settings where sophisticated neuropsychological testing is not available.

Original languageEnglish (US)
Pages (from-to)725-729
Number of pages5
JournalJournal of the American Geriatrics Society
Issue number8
StatePublished - Aug 1989

ASJC Scopus subject areas

  • Geriatrics and Gerontology


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