Validation of a Spanish translation of the CLOX for use in Hispanic samples: The Hispanic EPESE Study

Objectives: Clock drawing tests (CDT) appear to be less vulnerable to linguistic, cultural, or educational bias than traditional dementia screening instruments. We investigated a Spanish language translation of CLOX: an executive CDT, in a community sample of Hispanic elders. Methods: In-home CLOX evaluations of 1309 Mexican-American elders were reviewed. Results: Both CLOX1 (an executive CDT) and CLOX2 (a constructional CDT) showed good internal consistency (Chronbach's alpha; both α = 0.82). Cultural-demographic variables had little effect on CLOX scores. Although language had a significant effect on CLOX1 failure rates, this was not mediated by age, education, acculturation or income. Conclusions: These results suggest that the Spanish CLOX can be validly administered to community-based Hispanic elder samples regardless of education or acculturation.