Clock Drawing in the Montreal Cognitive Assessment: Recommendations for Dementia Assessment

Background: Clock drawing is part of the Montreal Cognitive Assessment (MoCA) test but may have administration and scoring limitations. We assessed (1) the reliability of the MoCA clock criteria relative to a published error scoring approach, (2) whether command-only administration could distinguish dementia from cognitively intact individuals and (3) the value of adding a clock copy condition to the MoCA. Methods: Three novice raters and clocks from dementia and control participants were used to assess the 3 aims. Results: MoCA interrater and intrarater reliability were low (i.e. intraclass correlation coefficient = 0.12–0.31) and required repeat training. Clocks drawn to command classified dementia at chance. Inclusion of a copy condition demonstrated expected dementia subgroup patterns. Conclusion: Reliable clock Accepted: January 24, 2011 Published online: March 10, 2011 Assist. Prof. Catherine C. Price, PhD Clinical and Health Psychology, University of Florida 101 S. Newell Drive, PO Box 100165 Gainesville, FL 32610 (USA) Tel. +1 352 273 5272, E-Mail cep23 @ phhp.ufl.edu © 2011 S. Karger AG, Basel Accessible online at: www.karger.com/dem D ow nl oa de d by : 54 .1 91 .4 0. 80 4 /8 /2 01 7 6: 25 :4 5 A M