Clock drawing has recently been shown to lie useful in differentiating Alzieimer's disease patients from normal controls. Our procedure for clock drawing differed from other published reports in that a copy condition was employed and patients were asked to set clock hands to read "ten after eleven". We found both clock drawing procedures to be correlated with tests related to executive and visuospatial functioning. In both conditions, nondemented controls performed significantly better than demented patients. In the command condition there was no difference between Alzheimer patients and patients with cerebrovascular dementia. In the copy condition, patients with cerebrovascular dementia performed significantly worse than Alzheimer patients. The inclusion of a copy condition appears to greatly expand the utility of this test. Although our scoring system did not differentiate between various dementing disorders in the command condition, if clock drawing is used as a screening instrument, lack of improvement in the copy condition in comparison to the command condition may be a sign of a vascular involvement.

Spontaneous communicative hand-arm gestures were evaluated in elderly patients with probable Alzheimer's disease (AD) and healthy controls (NC). Based on the notion that speech and gestures arise from common semantic-conceptual representations, qualitatively similar linguistic and gestural communicative impairments were expected in association with semantic memory impairment in AD. Despite equal quantity and rate of gesturing, AD and NC groups produced qualitatively different types of gestures. Patients with AD produced proportionately more referentially ambiguous gestures, fewer gestures referring to metaphoric as opposed to concrete contents, and fewer conceptually complex bimanual gestures. Impaired gestural clarity correlated with severity of linguistic/conceptual impairments and disturbed production of pantomimic movements on a test of ideomotor limb apraxia. Results are consistent with the hypothesis that a central semantic-conceptual disorder underlies the similar linguistic and gestural communication impairments in AD.

Clock drawing has recently been shown to lie useful in differentiating Alzieimer's disease patients from normal controls. Our procedure for clock drawing differed from other published reports in that a copy condition was employed and patients were asked to set clock hands to read "ten after eleven". We found both clock drawing procedures to be correlated with tests related to executive and visuospatial functioning. In both conditions, nondemented controls performed significantly better than demented patients. In the command condition there was no difference between Alzheimer patients and patients with cerebrovascular dementia. In the copy condition, patients with cerebrovascular dementia performed significantly worse than Alzheimer patients. The inclusion of a copy condition appears to greatly expand the utility of this test. Although our scoring system did not differentiate between various dementing disorders in the command condition, if clock drawing is used as a screening instrument, lack of improvement in the copy condition in comparison to the command condition may be a sign of a vascular involvement.

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