Use of the clock-drawing test in a hospice population.

Abstract

Cognitive impairment is common in patients with advanced disease and has significant implications for the patient, their carers and hospice staff. The effectiveness of screening tools is limited by a number of factors. The clock-drawing test (CDT) has performed well in other settings but has rarely been studied in the hospice setting. To assess the performance of the CDT in a hospice population. Consecutive admissions to a large hospice over three months were assessed using the CDT, the abbreviated mental test score and brief tests of attention and memory function. One-hundred and nine eligible patients were admitted and 77% took part. Thirty per cent were cognitively impaired. The CDT had a sensitivity of 0.92, a specificity of 0.73 and a negative predictive value of 0.95. No patient refused to complete it. The CDT performs well as a screening tool for cognitive impairment in a hospice population.