![]() The objective of this investigation was to examine the association between dCDT features and cognitive functions in the Framingham Heart Study (FHS) cohort. The digital pen can record its position with a timestamp and has excellent precision in capturing all graphomotor, spatial, and temporal information however, the characterization of these features and their correlations with standard neuropsychological tests has yet to be examined in a large community-based setting. Recently, a digital version of the CDT (dCDT) that uses a digital ballpoint pen and smart paper was developed as an alternative to the standard clock drawing scoring systems. However, none of these scoring systems can capture the full breadth of cognitive skills used in completing the test. Multiple manual scoring systems have been created to objectively quantify test performance. Keen observation of the process by which drawings are produced is key to the evaluation of the type and severity of cognitive impairment. The command test condition requires intact attention, auditory comprehension, semantic memory, executive function, and visuoconstructional abilities, whereas the copy test condition relies primarily upon visuospatial, attention, and executive function skills. Both test conditions require multiple cognitive domains. 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). 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. The composite scores derived from dCDT features were significantly associated with both neuropsychological tests and mild cognitive impairment.Ĭonclusions: The dCDT can potentially be used as a tool for cognitive assessment in large community-based populations. Each neuropsychological test was associated with an average of 50 dCDT features. Results: The study included 2062 participants (age: mean 62, SD 13 years, 51.6% women), among whom 36 were diagnosed with mild cognitive impairment. 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). 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. Participants were administered both the dCDT and a standard protocol of neuropsychological tests that measured a wide range of cognitive functions. Methods: Participants from the Framingham Heart Study, a large community-based cohort with longitudinal cognitive surveillance, who did not have dementia were included. Objective: We aimed to investigate the association between dCDT features and cognitive performance across multiple domains. 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. Recently, a digital Clock Drawing Text (dCDT) that is able to capture the entire sequence of clock drawing behaviors was introduced. JMIR Bioinformatics and Biotechnology 23 articlesĮmail: The Clock Drawing Test (CDT) has been widely used in clinic for cognitive assessment. ![]()
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