Clock drawing in the montreal cognitive assessment: Recommendations for dementia assessment

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

Research output: Contribution to journalArticlepeer-review

65 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)179-187
Number of pages9
JournalDementia and Geriatric Cognitive Disorders
Issue number3
StatePublished - Apr 2011
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology
  • Cognitive Neuroscience
  • Psychiatry and Mental health


Dive into the research topics of 'Clock drawing in the montreal cognitive assessment: Recommendations for dementia assessment'. Together they form a unique fingerprint.

Cite this