Abstract Aim To compare the psychometric properties, pragmatic screening cut‐offs, and feasibility of two Clock Drawing Test (CDT) formats in older psychiatric outpatients. Methods We retrospectively analyzed 447 outpatients aged ≥65 years who completed the Mini‐Mental State Examination (MMSE), the Hasegawa Dementia Scale‐Revised (HDS‐R), and two CDT formats scored using the Freedman method: a free‐drawn clock (CDT1) and an examiner‐provided clock face (CDT2). Pearson correlations, forced‐entry multiple regression models, exploratory factor analyses, and receiver operating characteristic (ROC) analyses were used. Possible cognitive impairment was operationally defined as MMSE ≤ 23 and/or HDS‐R ≤ 20. Administration time was summarized in a convenience subsample ( n = 20). Results Mean (SD) age was 80.20 (5.15) years, and mean education was 11.74 (2.36) years. CDT totals correlated positively with MMSE and HDS‐R totals ( r = 0.47–0.58, all p < 0.01). Education, functional disability, CDT1, and CDT2 predicted MMSE total, while age additionally predicted HDS‐R total. Both CDT formats showed interpretable two‐factor structures with good internal consistency (Cronbach's α 0.82–0.90). ROC analyses identified the same pragmatic cut‐off (10/11) for both formats (CDT1 area under the curve AUC 0.72, 95% CI 0.67–0.77; CDT2 AUC 0.71, 95% CI 0.66–0.76). Mean CDT administration time was 2.13 min. Conclusion Both CDT formats showed clinically useful psychometric properties and similar pragmatic cut‐offs in older psychiatric outpatients. CDT1 favored sensitivity, and CDT2 favored specificity at the same threshold. The CDT was highly feasible in routine practice, requiring approximately 2 min to administer.
Hatasaki et al. (Mon,) studied this question.
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