The utility of the ten-point clock test as a screen for cognitive impairment in general hospital patients

The object of this work was to illustrate the utility of the ten-point clock test as a screen for cognitive impairment in the general hospital by examining a range of diagnoses and estimating sensitivity for each. A total of 195 consecutive medical and surgical inpatients were examined who were referred for psychiatric consultation and histories from patient, family, nurses, physicians, and hospital records were obtained. Seventy-six percent of these patients were administered the ten-point clock test at the initial evaluation. The percentages of patients scoring less than 8 points on the ten-point clock test for the following primary diagnoses were delirium (92%), dementia (90%), and adjustment disorder (5%). Thirty-nine to seventy percent of patients with a delirium, dementia, opioid intoxication, or a cognitive disorder n. o. s. scored lower than 5 points but none of the patients with a major depressive disorder, alcohol dependence, or adjustment disorder did so. The sensitivities of the ten-point clock test and minimental state examinations appeared similar in a subset of patients. The ten-point clock test is a useful screen for cognitive impairment in general hospital patients. (C) 1997 Elsevier Science Inc.