![]() The test was jointly developed by the Massachusetts Institute of Technology and the Lahey Hospital and Medical Center with the collaboration of the Clock Sketch Consortium. Since October 2011, FHS participants who have come for their regular neuropsychological test visit were simultaneously administered the dCDT using a digital pen. We also investigated the association between dCDT features and cognitive status (clinically diagnosed mild cognitive impairment compared to those with normal cognition). 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.
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