The executive clock drawing task (CLOX) is a poor screening test for executive dysfunction in Chinese elderly patients with subcortical ischemic vascular disease

J Clin Neurosci. 2004 Jun;11(5):493-7. doi: 10.1016/j.jocn.2004.03.005.


Executive dysfunction (ED) is a prominent feature of subcortical ischemic vascular disease. A screening test for ED is lacking among Chinese. The objective of the study is to investigate the validity and reliability of a Chinese version of the Executive clock drawing task (CLOX) in screening ED among Chinese elderly patients with small subcortical infarct (SSI). The Chinese version of CLOX correlated with MMSE, CDRS I/P, and WCST perseverative errors. However, multivariate regression analysis showed that only education (R(2) change=0.22, p < 0.001 ) and MMSE (R(2) change=0.35, p < 0.001), but none of the standard executive function tests, significantly accounted for the variance in the CLOX. Test-retest (r=0.84) and inter-rater reliability (r=0.84) were high for the CLOX. Conclusions. Although the CLOX is reliable, it is not valid in detecting ED in Chinese elderly patients with SSI.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • China
  • Cognition Disorders / etiology*
  • Female
  • Geriatric Assessment
  • Humans
  • Male
  • Mass Screening
  • Mental Status Schedule / statistics & numerical data
  • Middle Aged
  • Neuropsychological Tests*
  • Problem Solving / physiology*
  • Psychometrics
  • Sensitivity and Specificity
  • Vascular Diseases / complications*
  • Vascular Diseases / diagnosis*