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Clock drawing in the Montreal Cognitive Assessment: recommendations for dementia assessment


Price, Catherine C., Cunningham, Holly, Coronado, Nicole, Freedland, Alana, Cosentino, Stephanie, Penney, Dana L., Penisi, Alfio, Bowers, Dawn, Okun, Michael S., Libon, David J.


Dementia And Geriatric Cognitive Disorders, Volume: 31, No.: 3, Pages.: 179-187

Year of Publication



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 scoring with MoCA criteria requires practice. Supplementing a clock copy to the standard MoCA test (takes <1 min) will improve dementia assessment.; Copyright © 2011 S. Karger AG, Basel.

Bibtex Citation

@article{Price_2011, doi = {10.1159/000324639}, url = {}, year = 2011, publisher = {S. Karger {AG}}, volume = {31}, number = {3}, pages = {179--187}, author = {Catherine C. Price and Holly Cunningham and Nicole Coronado and Alana Freedland and Stephanie Cosentino and Dana L. Penney and Alfio Penisi and Dawn Bowers and Michael S. Okun and David J. Libon}, title = {Clock Drawing in the Montreal Cognitive Assessment: Recommendations for Dementia Assessment}, journal = {Dementia and Geriatric Cognitive Disorders} }


aged, classification, clinical competence, dementia, diagnosis, diagnostics, disability evaluation, female, humans, male, mass screening, methods, middle aged, neuropsychological tests, observer variation, psychology, psychomotor performance, reproducibility of results, sensitivity and specificity, standards

Countries of Study


Types of Dementia

Dementia (general / unspecified), Mild Cognitive Impairment (MCI)

Types of Study

Instrument development and testing (cross walking of measures, etc.)

Type of Outcomes


Type of Interventions

Diagnostic Target Identification

Diagnostic Targets

Cognition testing (inc. task driven tests such as clock drawing)