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What is a Clock Test For Dementia And Alzheimer’s?

what is the clock test for dementia

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One of the conditions people fears the most these days is dementia. The most prevalent type of dementia, Alzheimer’s disease, is currently affecting the lives of over 6.5 million people in the United States. And by the year 2050, it is expected that this number will have skyrocketed to 14 million.

In-depth cognitive testing is typically required to determine whether a person with memory issues or mild cognitive impairment may eventually develop dementia.

However, a few additional straightforward tests might be really illustrative. Two new studies published in 2019 show that some brief tests can help determine whether or not a person has symptoms of dementia.

Are you concerned that someone you know and care about might exhibit signs of dementia? Of course, this is a normal worry, particularly as you become older and the people closest to you begin to forget things more frequently. 

The good news is – there is a straightforward test that you may do to figure out whether or not your concerns are warranted. One such test is the clock test for dementia. 

The clock test for dementia is a non-scientific way to detect cognitive decline. Drawing tests can be done at home or with the guidance of a professional expert to help diagnose dementia or Alzheimer’s.

It may be a sign of dementia if the person you care about can’t complete the clock test. Difficulties with memory, language, and reasoning are some of the symptoms included under the umbrella term dementia – it represents a deterioration in cognitive functioning. 

There are, of course, various reasons why a person might not pass the clock exam. A bad result does not necessarily indicate that the person has dementia. There are many things that can mimic symptoms of dementia.

For instance, a person may not perform well on the examination if they are extremely fatigued or if they are experiencing a great deal of stress. Age is also an important factor to consider. Naturally, as we become older, our abilities to complete higher level executive function in tasks can become more difficult to complete.

The clock drawing test is not conclusive on its own. But it can be used as part of a series of tests to help detect dementia and other forms of cognitive loss in their early stages. It’s an easy-to-use tool to track the development of dementia over time.

This test cannot be relied upon to diagnose dementia definitively. But it might tell you whether or not a cognitive evaluation should be considered for a loved one. 

Read on to know more about the clock test for dementia. So you will recognize when it is necessary to seek medical assistance for suspected dementia or Alzheimer’s disease.

This information is helpful whether you are a carer or are merely concerned about a family member.

Clock Test For Dementia And Alzheimer’s

As was mentioned in the beginning, the clock test for dementia is a straightforward approach. It can be used to assist in the identification of individuals who would benefit from additional dementia screening.

When you have reasons to believe that a friend or member of your family is struggling with some sort of cognitive impairment, you can put your suspicions to the test. 

You can use one of the wide varieties of this test, any of which can be carried out in the privacy and convenience of your own home. 

I must emphasize that this examination is not intended to be a definitive test. Instead, the clock test is just one of many possible diagnostic procedures that can be utilized to help contribute to a diagnosis of dementia.

It is only after a thorough clinical evaluation of a healthcare professional that dementia can be diagnosed in a patient. 

The digital clock-drawing exam is used specifically to measure executive function. The executive function encompasses various responsibilities, including planning, organization, and adaptability. 

People who have dementia usually see a deterioration in these abilities. Therefore, if a person is unable to complete the test within the allotted amount of time, this may be an early indicator of the condition. 

Explain how the procedure for the test is carried out. Although there are several distinct iterations of the clock test, they are all predicated on the same fundamental assumption. 

The purpose of this activity is to determine whether the individual in question can sketch a simple clock correctly. If they cannot finish the drawing correctly, this could be a sign that they have cognitive impairment. 

The inability to read regular clocks is a common symptom of dementia, which is why the clock-drawing test is effective at diagnosing mental deterioration.

To interpret the position of the hands on a clock and determine the time that each hand is supposed to represent, you need to be able to read the time. Unfortunately, those living with dementia typically experience difficulties with higher level tasks required to draw a clock or read time effectively.

How is it Done?

A physician or other medical expert can administer the clock-drawing test.

Before anything else, the physician will inquire as to whether or not the individual can draw the numbers that are on the clock face. After that, the individual will be prompted to sketch the hands of a clock in order to indicate a particular time. 

There are a variety of possible times to employ, but the majority of medical professionals agree that 10 minutes after 11 is the most reliable estimate. 

One possible version of the test involves handing the individual a sheet of blank paper and requesting that they draw a clock indicating that it is ten minutes after eleven. 

And to prevent the person from getting any hints, the word “hands” is never spoken. In most cases, three separate drawings are required, each of which must be completed within a predetermined amount of time.


The clock-drawing test can be graded in as many as fifteen different ways. So, depending on the approach, you could get 10, 15, or 20 points for getting the series of numbers, the arrangement of numbers, and the positioning of the hands just so.

The interpretation can also be affected by errors like missing numbers, misplaced hands, repeated numbers, the improper sequence of numbers, or the wrong time.

If the drawing is correct, the player receives one point; otherwise, they receive no points under this system. The simplest method is just as accurate as the most complex one in identifying early dementia, according to a study published in the Danish Medical Journal in 2012.

The Alzheimer’s Association, on the other hand, supports the straightforward scoring system.

What if a Person Fails?

If you have given the clock drawing exam to a close friend or member of your family, you can begin to worry if they draw an odd clock or times that differ from what you have asked them to draw.

Although this may be an indication that the person you care about has Alzheimer’s disease or dementia, this is not always the case. This is due to the fact that the clock test is only capable of identifying cognitive deficiencies and not a specific disease.

In order for your loved one to do well on a test like this, they must first understand the verbal instructions, in order for them to complete what you are requesting from them.

In addition to that, they need to have an awareness of space, a good visual memory, and the capacity to think abstractly. They will not be able to perform very well on the timed test if even one of these things is lacking.

Depending on which aspects of the clock the individual is able to complete, a failed clock test could indicate Parkinson’s disease, Huntington’s disease, Alzheimer’s disease, vascular dementia, frontotemporal dementia, or dementia with Lewy bodies.

Because of this, you shouldn’t jump to the conclusion that your loved one failed the clock test as the definitive answer to the question of whether or not they have dementia. Instead, you should take your loved one’s failure to pass the clock test as evidence that they require the assistance of a trained specialist.

Why Does a Clock Test Work?

Why Does a Clock Test Work

The act of drawing a clock may seem elementary, but here are the critical steps:

  • Verbal comprehension
  • Spatial awareness
  • Visual recall
  • Abstract reasoning

A person’s ability to follow directions depends on their ability first to hear them and then mentally translate them into the appropriate behavior. For example, to really draw a clock from the instruction “Draw a clock,” one needs to use their brain. 

Unfortunately, those with Alzheimer’s disease or other kinds of dementia usually have difficulty with abstract thought. Therefore, following directions after hearing them might be challenging.

It also requires preparation or an awareness of the necessary steps. For example, the brain has to know how to draw a circle before it can learn to draw numbers or use its hands. As such, you’ll need to rely on your visual memory to recall how a clock generally appears.

In the end, there’s abstract reasoning. For example, requesting “10 minutes after 11” is a good idea because the brain needs time to process the information. 

A person whose brain is unable to comprehend information appropriately might depict hands pointing to the 10 and 11. It requires some extra work to realize that “10 after” refers to an arrow pointing toward the number 2.

When shared with close ones, a drawing of a clock can also convey profound meaning. Unlike the numerical score on a Q&A test, which has the force of a clock with evident mistakes, this one image can indicate a loved one’s mental state.

Upsides And Downsides

Upsides And Downsides

Dementia should be diagnosed as soon as possible. This is because early treatment can help slow the progression of diseases like Alzheimer’s. In this regard, the clock-drawing exam has advantages in that:

1. It’s Fast And Easy to do

This quick and easy test can be done with just a pencil and paper.

2. It’s Quite Straightforward to Use

If a basic system of scoring is utilized, the test does not necessitate extensive preparation.

3. Can Test For Delirium

The test can also identify the cognitive decline associated with delirium. Instead of mental deterioration, the cause could be something like a serious sickness, brain infection, or drug reaction.

However, the clock-drawing test is not without its flaws. To name just a few constraints:

The Underlying Dementia Kind Cannot be Identified

The test may provide a reliable indicator of early dementia. But it cannot distinguish between Alzheimer’s disease and other causes of cognitive decline. Various further examinations would be required to do so.

It’s Prone to Misconceptions

For example, if the person conducting the test is not a medical expert, they can incorrectly diagnose vascular dementia as Alzheimer’s.

Closing Thoughts

It’s terrifying to suspect that a loved one is experiencing Alzheimer’s or dementia. However, administering the clock test in the comfort of your own home may help to identify some areas of cognitive concern.

Screening for dementia like Alzheimer’s disease can be done rapidly with the clock-drawing test. A clock is drawn on paper using numbers, hands, and the given time. The incapacity to do so is indicative of a deteriorating mental state.

However, the clock-drawing test cannot differentiate between different types of dementia or other causes of cognitive decline, such as a major illness, cerebral infections, or drug reactions.

But remember, the clock test isn’t meant to replace a doctor’s diagnosis. If a member of your family fails the clock test, it’s a red flag that something is amiss. 

A trained medical professional should be contacted when any cognitive concerns arise.

Seek a professional medical opinion if you or a loved one exhibits symptoms consistent with Alzheimer’s disease or another form of dementia. For example, a general practitioner, neurologist, or geriatrician may be on your list of potential doctors to see.

These medical professionals can help rule out anything that could be contributing to symptoms that could be presenting as dementia, which is why it’s important to always contact a medical professional to  determine if dementia is evident.


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