Digital clock assessment in South Asian setting: pilot study

Area of Science:

• Neurology
• Gerontology
• Digital Health

Background:

• Cognitive impairment poses a growing challenge, particularly in low- and middle-income countries.
• Scalable tools are essential for early detection and intervention.
• Digital health solutions offer promise for accessible cognitive screening.

Purpose of the Study:

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

Main Methods:

• Pilot study involving 303 adults aged ≥ 50 years in urban India.
• Administration of both tablet-based DCTclock and paper-based Mini-Cog.
• Comparison of DCTclock performance between cognitively impaired and unimpaired groups.

Main Results:

• The DCTclock was feasible, administered in under four minutes with 99.3% analyzable data.
• Cognitively impaired participants scored significantly lower on the DCTclock, especially in spatial reasoning and information processing.
• The DCTclock showed moderate discriminative accuracy (AUC = 0.669) for Mini-Cog-defined impairment.

Conclusions:

• The tablet-based DCTclock is a feasible and potentially scalable tool for community-based cognitive screening.
• The DCTclock shows promise for early detection of cognitive impairment in diverse populations.
• Digital tools like DCTclock can help address the growing burden of cognitive decline in resource-limited settings.