Objective: Evaluate an automated digital tool for administering and scoring the Clock Drawing Test (CDT) in a movement disorders clinic.

Background: The CDT is a widely used test of visuospatial and executive functions, included in screening tests such as the MoCA and Mini-Cog. It was adapted for tablet-based administration using the Manus Neuromotor digital pen to assess kinemetrics (e.g, speed, hesitation, etc.) and an algorithm was developed for automated scoring of features. Clinical utility in neuropsychological evaluations of movement disorder patients has not been reported.

Method: The digital CDT is being administered in clinical neuropsychological evaluations by two fellowship-trained neuropsychologists.  Digital CDT scores will be compared to traditional scoring (3-point from MoCA and 10-point from Sunderland). Associations will be examined between the automatic scoring systems and other visuospatial measures in a sample of n=60 consecutive patients.  Sensitivity to cognitive impairment will also be examined.

Results: To date, n=13 patients (3 normal cognition, 6 mild cognitive impairment, 4 dementia) have completed the digital CDT.  Preliminary analyses indicate moderate association with the traditional 3-point (rho=.73) and 10-point (rho=.86) scoring systems.  Sensitivity to cognitive impairment also appears similar between systems.

Conclusion: The digital CDT appears to provide similar information regarding visuospatial and executive functioning as traditional scoring with the benefit of an instant scoring system.  Analyses based on the full sample will indicate whether inclusion of kinemetrics improves sensitivity to impairment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/time-for-a-digital-clock/