Age and Graphomotor Decision Making Assessed with the Digital Clock Drawing Test: The Framingham Heart Study

J Alzheimers Dis. 2017;60(4):1611-1620. doi: 10.3233/JAD-170444.

Abstract

Background: Digital Clock Drawing Test (dCDT) technology enables the examination of detailed neurocognitive behavior as behavior unfolds in real time; a capability that cannot be obtained using a traditional pen and paper testing format.

Objective: Parameters obtained from the dCDT were used to investigate neurocognitive constructs related to higher-order neurocognitive decision making and information processing speed. The current research sought to determine the effect of age as related to combined motor and non-motor components of drawing, and higher-order decision making latencies.

Methods: A large group of stroke- and dementia- free Framingham Heart Study participants were administered the dCDT to command and copy with hands set for "10 after 11". Six age groups (age range 28-98) were constructed.

Results: Differences between age groups were found for total time to completion, total pen stroke count, and higher-order decision making latencies in both command and copy test conditions.

Conclusion: Longer age-related decision making latencies may reflect a greater need for working memory and increased self-monitoring in older subjects. These latency measures have potential to serve as neurocognitive biomarkers of Alzheimer's disease and other insidious neurodegenerative disorders.

Keywords: Boston Process Approach; cognition; digital clock drawing test; graphomotor decision making; normal aging.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / epidemiology
  • Decision Making*
  • Female
  • Geriatric Assessment / methods*
  • Humans
  • Longitudinal Studies
  • Male
  • Massachusetts
  • Middle Aged
  • Motor Skills*
  • Multivariate Analysis
  • Neuropsychological Tests*
  • Reaction Time