Cognitive Screening: Using the Clock-Drawing Test to Assess for Preexisting Deficits in Older Women Diagnosed With Breast Cancer

Janine Overcash, PhD, GNP-BC, FAANP; Maddy Perry, BSN, RN


Background: Older women diagnosed with breast cancer may also have preexisting cognitive deficits.

Objectives: The aim of the current study is to describe errors on the clock-drawing test (CDT), which is used to screen for preexisting cognitive deficits in older women diagnosed with breast cancer.

Methods: This descriptive study included a convenience sample of women aged 69 years or older with a diagnosis of breast cancer. The CDT was used to screen for cognitive deficits, such as size of the clock, graphic difficulties, stimulus-bound response, conceptual deficit, spatial and/or planning deficit, and perseveration. Data were analyzed by the Rouleau qualitative error analysis.

Findings: Many older adult patients exhibit some abnormality on the CDT. Most abnormalities were spatial/planning difficulties. Cognitive screening should be included in the comprehensive assessment of older adults diagnosed with breast cancer to screen for preexisting cognitive limitations.

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