Scoring: normal (perfect or near perfect) or abnormal by inspection any abnormal clock should raise suspicion of dementia and prompt further evaluation.Test: “Please draw a clock and make the time show 10 minutes past 11:00.”.This test involves one item, and takes one to two minutes to administer. Ask the patient to recall the three words.The scoring of the clock is similar to the Mini-Cog scoring described on page 229. Use the clock-drawing test (see below) as a distracter for the three-word recall.I want you to repeat them back to me.” Explain that you will later ask the patient to recall the words. Tell the patient: “I am going to say three words.The Mini-Cog combines the delayed three-word recall test and the clock-drawing test (Borson et al., 2000). The Mini-Cog is a first-line cognitive screen for primary care, although it has not been evaluated as extensively as the MMSE or the Montreal Cognitive Assessment. Cons: takes longer than other similar tests tests a limited number of cognitive domains (relatively less emphasis on memory and executive functioning) often not sensitive to early cognitive change.Pros: familiar and takes a relatively short time to administer.
Test items that are most sensitive to detection: orientation to date (especially year), delayed word recall and intersecting pentagons.Performance affected by age and education.
Text adapted from "The patient with dementia" in Psychiatry in primary care by Kenneth Le Clair, Dallas Seitz and Julia Kirkham.
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