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Area of Science:

  • Neurology
  • Gerontology
  • Digital Health

Background:

  • Cognitive impairment poses a significant challenge in low- and middle-income countries.
  • Scalable and accessible early detection tools are crucial for managing cognitive decline.
  • The Clock Drawing Test is a widely used cognitive screening tool.

Purpose of the Study:

  • To evaluate the feasibility and performance of a tablet-based digital Clock Drawing Test (DCTclock).
  • To assess the DCTclock's utility for cognitive screening in a population-based cohort in urban India.

Main Methods:

  • A pilot study involving 303 adults aged 50+ in urban India.
  • Participants completed both DCTclock and paper-based Mini-Cog for cognitive status classification.
  • Analyzed DCTclock scores, demographic factors, and discriminative accuracy against Mini-Cog results.

Main Results:

  • DCTclock administration was rapid (<4 minutes) with high analyzable output (99.3%).
  • Impaired participants scored significantly lower on DCTclock, particularly in spatial reasoning and information processing.
  • DCTclock showed moderate accuracy (AUC=0.669) in identifying Mini-Cog-defined impairment, with specific score thresholds indicating higher impairment odds.

Conclusions:

  • The tablet-based DCTclock is a feasible and potentially valuable tool for cognitive screening in resource-limited settings.
  • Digital clock drawing can support aging surveillance and dementia risk stratification.
  • Further application of DCTclock in diverse populations is warranted.