Introduction: The Clock Drawing Test (CDT) is popular amongst professionals such as neuropsychologists and neurologists working with dementia patients as well as among a wider range of physicians, including general practitioners. The purpose of this study is to investigate the capacity of CDT to distinguish mild from moderate dementia and to determine relevant cut-off thresholds for three popular scoring systems. Material and methods: Forty-six patients with Alzheimer's disease were included. They were tested using MMSE and CDT. The latter was scored according to the systems proposed by Sunderland, Shulman and Lam. T-test and ROC analysis were performed. Results: According to MMSE, patients were classified as having mild or moderate dementia. Significant differences between the CDT scores of the two groups were found for the Sunderland and Lam methods (p <0.01), and for the Shulman method (p <0.05). Optimal threshold values distinguishing mild from moderate dementia were <4 (Sunderland), > 4 (Shulman), and> 6 (Lam). Discussion: Determining the severity of dementia is important not only for understanding the extent to which the patient is dependent on care, but also for determining the appropriate treatment. The availability of short neuropsychological instruments with good sensitivity and specificity, such as CDT, enables specialists to be more flexible in their practice.
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