Iranian Journal of Psychiatry and Behavioral Sciences

Published by: Kowsar

Psychometric Properties of the Persian Version of the Clock Drawing Test (CDT) Among the Aged People in Iran

Masoumeh Sadeghipour Roudsari 1 , Ahmad Ali Akbari Kamrani 2 , Mahshid Foroughan 2 , * , Farahnaz Mohammadi Shahboulaghi 3 and Masoud Karimlou 4
Authors Information
1 Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
2 Iranian Research Centre on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
3 Department of Gerontology and Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
4 Department of Epidemiology and Biostatistics, Faculty of Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
Article information
  • Iranian Journal of Psychiatry and Behavioral Sciences: 12 (4); e63386
  • Published Online: September 12, 2018
  • Article Type: Original Article
  • Received: October 29, 2017
  • Revised: January 22, 2018
  • Accepted: August 9, 2018
  • DOI: 10.5812/ijpbs.63386

To Cite: Sadeghipour Roudsari M, Akbari Kamrani A A, Foroughan M , Mohammadi Shahboulaghi F, Karimlou M. Psychometric Properties of the Persian Version of the Clock Drawing Test (CDT) Among the Aged People in Iran, Iran J Psychiatry Behav Sci. Online ahead of Print ; 12(4):e63386. doi: 10.5812/ijpbs.63386.

Copyright © 2018, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Materials and Methods
4. Results
5. Discussion
  • 1. Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: A systematic review and metaanalysis. Alzheimers Dement. 2013;9(1):63-75 e2. doi: 10.1016/j.jalz.2012.11.007. [PubMed: 23305823].
  • 2. Salomon JA, Wang H, Freeman MK, Vos T, Flaxman AD, Lopez AD, et al. Healthy life expectancy for 187 countries, 1990 - 2010: A systematic analysis for the global burden disease study 2010. Lancet. 2012;380(9859):2144-62. doi: 10.1016/S0140-6736(12)61690-0. [PubMed: 23245606].
  • 3. Noroozian M. The elderly population in iran: An ever growing concern in the health system. Iran J Psychiatry Behav Sci. 2012;6(2):1-6. [PubMed: 24644476]. [PubMed Central: PMC3940007].
  • 4. Statistical Centre of Iran. Population and housing censuses. 2016. Available from:
  • 5. Mate KE, Magin PJ, Brodaty H, Stocks NP, Gunn J, Disler PB, et al. An evaluation of the additional benefit of population screening for dementia beyond a passive case-finding approach. Int J Geriatr Psychiatry. 2017;32(3):316-23. doi: 10.1002/gps.4466. [PubMed: 26988976].
  • 6. Shulman KI. Clock-drawing: Is it the ideal cognitive screening test? Int J Geriatr Psychiatry. 2000;15(6):548-61. doi: 10.1002/1099-1166(200006)15:6<548::AID-GPS242>3.0.CO;2-U. [PubMed: 10861923].
  • 7. Aprahamian I, Martinelli JE, Neri AL, Yassuda MS. The clock drawing test: A review of its accuracy in screening for dementia. Dement Neuropsychol. 2009;3(2):74-81. doi: 10.1590/S1980-57642009DN30200002. [PubMed: 29213615]. [PubMed Central: PMC5619222].
  • 8. Pinto E, Peters R. literature review of the clock drawing test as a tool for cognitive screening. Dement Geriatr Cogn Disord. 2009;27(3):201-13. doi: 10.1159/000203344. [PubMed: 19225234].
  • 9. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98. doi: 10.1016/0022-3956(75)90026-6. [PubMed: 1202204].
  • 10. Nair AK, Gavett BE, Damman M, Dekker W, Green RC, Mandel A, et al. Clock drawing test ratings by dementia specialists: Interrater reliability and diagnostic accuracy. J Neuropsychiatry Clin Neurosci. 2010;22(1):85-92. doi: 10.1176/appi.neuropsych.22.1.85. [PubMed: 20160214]. [PubMed Central: PMC2938787].
  • 11. Fuzikawa C, Lima-Costa MF, Uchoa E, Barreto SM, Shulman K, Bambui H, et al. A population based study on the intra and inter-rater reliability of the clock drawing test in Brazil: The bambui health and ageing study. Int J Geriatr Psychiatry. 2003;18(5):450-6. doi: 10.1002/gps.863. [PubMed: 12766923].
  • 12. Atalaia-Silva KC, Lourenco RA. Translation, adaptation and construct validation of the clock test among elderly in Brazil. Rev Saude Publica. 2008;42(5):930-7. [PubMed: 18833391].
  • 13. Can SS, Gencay-Can A, Gunendi Z. Validity and reliability of the clock drawing test as a screening tool for cognitive impairment in patients with fibromyalgia. Compr Psychiatry. 2012;53(1):81-6. doi: 10.1016/j.comppsych.2011.02.001. [PubMed: 21571264].
  • 14. Storey JE, Rowland JT, Basic D, Conforti DA. A comparison of five clock scoring methods using ROC (receiver operating characteristic) curve analysis. Int J Geriatr Psychiatry. 2001;16(4):394-9. [PubMed: 11333427].
  • 15. Mainland BJ, Amodeo S, Shulman KI. Multiple clock drawing scoring systems: Simpler is better. Int J Geriatr Psychiatry. 2014;29(2):127-36. doi: 10.1002/gps.3992. [PubMed: 23765914].
  • 16. Sadeghipour Roodsari M, Akbari Kamrani AA, Foroughan M, Mohammadi F, Karimloo M. [Validity and reliability of the clock drawing test in older people]. Iran J Ageing. 2013;8(2):48-53. Persain.
  • 17. Ehtezazi P, Noroozian M, Seyedian M, Ghassemzadeh H, Nejat S. [A preliminary study on the validation of Persian clock test in the elderly population refering to Tamin Ejtemaee Clinic from March 5th to April 5th 2006]. Tehran: Tehran University of Medical sciences; 2006. Persian.
  • 18. Shulman KI, Pushkar Gold D, Cohen CA, Zucchero CA. Clock‐drawing and dementia in the community: A longitudinal study. Int J Geriatr Psychiatry. 1993;8(6):487-96. doi: 10.1002/gps.930080606.
  • 19. Richardson HE, Glass JN. A comparison of scoring protocols on the clock drawing test in relation to ease of use, diagnostic group, and correlations with mini-mental state examination. J Am Geriatr Soc. 2002;50(1):169-73. [PubMed: 12028263].
  • 20. Nishiwaki Y, Breeze E, Smeeth L, Bulpitt CJ, Peters R, Fletcher AE. Validity of the clock-drawing test as a screening tool for cognitive impairment in the elderly. Am J Epidemiol. 2004;160(8):797-807. doi: 10.1093/aje/kwh288. [PubMed: 15466502].
  • 21. Cecato JF, Fiorese B, Montiel JM, Bartholomeu D, Martinelli JE. Clock drawing test in elderly individuals with different education levels: Correlation with clinical dementia rating. Am J Alzheimers Dis Other Demen. 2012;27(8):620-4. doi: 10.1177/1533317512463954. [PubMed: 23118201].
  • 22. Malakouti K, Fathollahi P, Mirabzadeh A, Salavati M, Kahani SH. [Validation of geriatric depression scale (GDS-15) in Iran]. Res Med. 2006;30(4):361-9. Persain.
  • 23. Foroughan M, Farahani ZG, Shariatpanahi M, Vaezinejad M, Kamerani AA, Sheikhvatan M. Risk factors of alzheimer's disease among Iranian population. Curr Alzheimer Res. 2008;5(1):70-2. [PubMed: 18288934].
  • 24. Schramm U, Berger G, Muller R, Kratzsch T, Peters J, Frolich L. Psychometric properties of clock drawing test and MMSE or short performance test (SKT) in dementia screening in a memory clinic population. Int J Geriatr Psychiatry. 2002;17(3):254-60. [PubMed: 11921154].
  • 25. Aprahamian I, Martinelli JE, Neri AL, Yassuda MS. The accuracy of the clock drawing test compared to that of standard screening tests for Alzheimer's disease: Results from a study of Brazilian elderly with heterogeneous educational backgrounds. Int Psychogeriatr. 2010;22(1):64-71. doi: 10.1017/S1041610209991141. [PubMed: 19814841].
  • 26. Fuzikawa C, Lima-Costa MF, Uchoa E, Shulman K. Correlation and agreement between the mini-mental state examination and the clock drawing test in older adults with low levels of schooling: The bambui health aging study (BHAS). Int Psychogeriatr. 2007;19(4):657-67. doi: 10.1017/S1041610207005467. [PubMed: 17506917].
  • 27. Kim H, Chey J. Effects of education, literacy, and dementia on the clock drawing test performance. J Int Neuropsychol Soc. 2010;16(6):1138-46. doi: 10.1017/S1355617710000731. [PubMed: 20961480].
  • 28. Leung JCW, Lui VWC, Lam LCW. Screening for early alzheimer's disease in elderly chinese patients using the chinese clock drawing test. Hong Kong J Psychiatry. 2005;15(1):14-8.
  • 29. Lin KN, Wang PN, Chen C, Chiu YH, Kuo CC, Chuang YY, et al. The three-item clock-drawing test: A simplified screening test for alzheimer's disease. Eur Neurol. 2003;49(1):53-8. doi: 10.1159/000067026. [PubMed: 12464719].
  • 30. Nitrini R, Caramelli P, Herrera Junior E, Porto CS, Charchat-Fichman H, Carthery MT, et al. Performance of illiterate and literate nondemented elderly subjects in two tests of long-term memory. J Int Neuropsychol Soc. 2004;10(4):634-8. doi: 10.1017/S1355617704104062. [PubMed: 15327741].
  • 31. Lourenco RA, Ribeiro-Filho ST, Moreira Ide F, Paradela EM, Miranda AS. The Clock drawing test: Performance among elderly with low educational level. Rev Bras Psiquiatr. 2008;30(4):309-15. [PubMed: 19142404].
Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments