Health

Screen For Dementia With The Stroke Of A Clock

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What if I asked you to draw a clock, then place the hands of the clock at 10 till two—could you do it? You probably could. But what may seem like a simple task for you may not be so simple for someone with a neurodegenerative disease, and that makes it an extremely useful tool for doctors when screening potential dementia patients. Drawing a clock is a quick way to assess mental function.

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The progressive deterioration of pattern processing ability in a subject as they progress from mild cognitive impairment (MCI) to severe Alzheimer's disease (AD).

Ten Till Two

Alzheimer's Disease is slow-progressing neurological disease that destroys connections between brain cells. It's also the most common form of dementia. Unfortunately, the only way you can know for sure that someone has Alzheimer's is to examine their brain—something that can only be done after death. But even though there isn't a definitive test to diagnose a living Alzheimer's patient, the clock-drawing test is extremely accurate as an assessment tool.

The test can take a number of different forms, but generally begins with the physician handing the patient a blank sheet of paper and asking them to draw a clock from memory. Sometimes the test includes a pre-drawn circle that the patient needs to fill in with numbers; other times there's a clock with no hands that the patient needs to fill in with a certain time of day.

Time Reveals Everything

The results can be illuminating. Omaha.com reported on an art exhibition of these drawings that anesthesiologist Andy Peck put together in 2016. "Some of the nearly 150 on display look like old-school wrist watches. Others, like cartoonish, overblown flowers, with miniature petals and a large circular middle, no numbers to be seen. [...] Some of the most shocking drawings came from people who, Peck said, 'seemed to be with it.' But the clocks they would return would look like something out of a Salvador Dali painting, warped and confused. Their disease is much more advanced than one would think based on daily interactions."

While the clock-drawing test doesn't substitute for a true diagnostic work-up, Peck says, "I don't think there's a neurologist that doesn't use it." It's a simple, cheap, and fast way to assess the state of a patient's brain—and, what's more, it can show in a single glance what people may not admit to themselves. As Peck says, "The world they're living in is more confusing than their loved ones want to believe."

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