Clock of the Week – Dementia

Clock drawing of 78-year old male with advanced dementia
WESTBOROUGH, MA February 1, 2016 This clock was drawn by a 78-year old man who was referred for outpatient neuropsychological assessment to determine the extent of change in dementia from his initial testing 24 months earlier.  You can learn quite a bit from the drawings of people thought to be suffering from dementia.  In this case, the patient was friendly and compliant.  He put forth a good effort and worked with diligence and earnest.  The task is the same for all cases – “draw a clock, put all the numbers on it and set the hands for 11:10.”
This clock effectively demonstrated the decline in the gentleman’s neurocognition.  It was poorly organized.  There was some neglect of the left hemi-space.  He had no self-monitoring or internal executive capacity to guide his construction.  He seemed surprised when I pointed out his work.  The numbers were not correctly placed. The slash marks were meant as minute marks and not number 11.  However, there were repeated numerals and reversals.  No hands were placed.
I learned about cognitive testing while an intern at Boston City Hospital – now B.U. Medical Center in the South End.  I loved my time there.  I wrote a blog about clocks and the utility of the clock drawing about a year ago called “All this from a Clock”.  If interested in the clock drawing take a look at the link I posted.

One thought on “Clock of the Week – Dementia

  1. […] WESTBOROUGH, MA July 7, 2016 The clock drawing is something that I have grown quite fond of using to assess patients who might be impaired in their thinking skills. Here is the clock of the week for early July, 2016. Some patients become suspicious when the neuropsychologist gets involved often saying “What do they think I am crazy?”  No not at all.  But the clock drawing can provide a great deal of important clinical information about their cognitive functioning.  I have written about the clock drawing and other visuospatial functions for a few years now.  As you can see by the clock of the week for July 7th the patient who crafted this clock missed the boat.  I needed to prompt him for everything including placing the numbers around the clock.  The clock is nonthreatening.  Patients sometimes believe that the tests we use in our assessments require a high level of education.  Not true.  I published a post in January about the impact of dementia on caregivers […]

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