Abstract
BackgroundThe Clock Drawing Test (CDT) has been widely used in clinic for cognitive assessment. Recently, a digital Clock Drawing Text (dCDT) that is able to capture the entire sequence of clock drawing behaviors was introduced. While a variety of domain-specific features can be derived from the dCDT, it has not yet been evaluated in a large community-based population whether the features derived from the dCDT correlate with cognitive function.ObjectiveWe aimed to investigate the association between dCDT features and cognitive performance across multiple domains.MethodsParticipants from the Framingham Heart Study, a large community-based cohort with longitudinal cognitive surveillance, who did not have dementia were included. Participants were administered both the dCDT and a standard protocol of neuropsychological tests that measured a wide range of cognitive functions. A total of 105 features were derived from the dCDT, and their associations with 18 neuropsychological tests were assessed with linear regression models adjusted for age and sex. Associations between a composite score from dCDT features were also assessed for associations with each neuropsychological test and cognitive status (clinically diagnosed mild cognitive impairment compared to normal cognition).ResultsThe study included 2062 participants (age: mean 62, SD 13 years, 51.6% women), among whom 36 were diagnosed with mild cognitive impairment. Each neuropsychological test was associated with an average of 50 dCDT features. The composite scores derived from dCDT features were significantly associated with both neuropsychological tests and mild cognitive impairment.ConclusionsThe dCDT can potentially be used as a tool for cognitive assessment in large community-based populations.
Highlights
The Clock Drawing Test (CDT) is a widely used neuropsychological test to screen cognitive impairment and dementia because of its ease of administration and clinical assessment capability [1,2]
Associations between a composite score from digital Clock Drawing Text (dCDT) features were assessed for associations with each neuropsychological test and cognitive status
The composite scores derived from dCDT features were significantly associated with both neuropsychological tests and mild cognitive impairment
Summary
The Clock Drawing Test (CDT) is a widely used neuropsychological test to screen cognitive impairment and dementia because of its ease of administration and clinical assessment capability [1,2]. The test is typically administered by specifying a time, for example, ten past eleven, and asking patients or participants to draw a clock showing that time (the command condition), followed by asking patients or participants to copy a predrawn clock image (the copy condition). Both test conditions require multiple cognitive domains. Multiple manual scoring systems have been created to objectively quantify test performance None of these scoring systems can capture the full breadth of cognitive skills used in completing the test [3]. While a variety of domain-specific features can be derived from the dCDT, it has not yet been evaluated in a large community-based population whether the features derived from the dCDT correlate with cognitive function
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