Qualitative analysis of the Clock Drawing Test by educational level and cognitive profile

The use of a qualitative scale for the Clock Drawing Test (CDT) may add information about the pattern of errors committed. Objective: To translate and adapt the Modified Qualitative Error Analysis of Rouleau into Brazilian Portuguese and to examine the pattern of errors according to educational level and cognitive profile. Method: 180 adults (47-82 years) completed the CDT. Participants were stratified into age and educational levels and separated between those with and without changes in cognitive screening tests (Mini-Mental State Examination, Verbal Fluency). Results: No significant differences were found in CDT scores among age groups. Among participants without cognitive impairment, those with lower education often presented graphic difficulties, conceptual deficits and spatial deficits. Participants with cognitive deficits, demonstrated more frequently conceptual and spatial errors. Conclusion: The qualitative analysis of the CDT may contribute to the identification of cognitive changes. Education level has to be taken into consideration during the analysis.

针对画钟测验（Clock Drawing Test, CDT）采用定性量表评分，可补充获取受试在测验中所犯错误的类型分布相关信息。
目的：将鲁洛（Rouleau）修正版定性错误分析量表翻译并适配为巴西葡萄牙语版本，并依据受教育水平与认知特征分析画钟测验的错误类型分布。
方法：共纳入180名年龄介于47至82岁的成年人完成画钟测验。研究人员按年龄与受教育水平对受试者进行分层，并根据其认知筛查测验——简易精神状态检查量表（Mini-Mental State Examination）、言语流畅性测验（Verbal Fluency）——的结果是否存在异常分为两组。
结果：不同年龄组的画钟测验得分未发现显著差异。在无认知损伤的受试者中，受教育水平较低者常出现绘图困难、概念性缺损与空间性缺损；而存在认知缺损的受试者则更频繁地表现出概念性与空间性错误。
结论：对画钟测验开展定性分析，有助于识别认知功能异常；在分析过程中需充分考量受试者的受教育水平因素。