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

Article type: Research Article

Authors: Piers, Ryan J.^{a; b} | Devlin, Kathryn N.^c | Ning, Boting^d | Liu, Yulin^b | Wasserman, Ben^b | Massaro, Joseph M.^{b; d} | Lamar, Melissa^e | Price, Catherine C.^f | Swenson, Rod^g | Davis, Randall^h | Penney, Dana L.ⁱ | Au, Rhoda^{b; j; 1; *} | Libon, David J.^{k; 1}

Affiliations: [a] Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA | [b] Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA | [c] Department of Psychology, Temple University, Philadelphia, PA, USA | [d] Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA | [e] Rush Alzheimer’s Disease Center, Chicago, IL, USA | [f] Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA | [g] Department of Neuroscience, North Dakota School of Medicine, Grand Forks, ND, USA | [h] MIT CSAIL, Cambridge, MA, USA | [i] Department of Neurology, Lahey Hospital and Medical Center, Burlington, MA, USA | [j] Department of Anatomy & Neurobiology, Neurology, & Epidemiology, Boston University Schools of Medicine & Public Health, Boston, MA, USA | [k] Department of Geriatrics and Gerontology and the Department of Psychology, New Jersey Institute for Successful Aging, Rowan University, School of Osteopathic Medicine, Stratford, NJ, USA

Correspondence: [*] Correspondence to: Rhoda Au, PhD, Department of Anatomy & Neurobiology, Neurology, & Epidemiology, Boston University Schools of Medicine & Public Health, 72 East Concord Street, B-612, Boston, MA 02118-2526, USA. Tel.: +1 617 638 4200; Fax: +1 617 638 4216; E-mail: [email protected].

Note: [1] These authors contributed equally as senior authors.

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

DOI: 10.3233/JAD-170444

Journal: Journal of Alzheimer's Disease, vol. 60, no. 4, pp. 1611-1620, 2017