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

Ryan J. Piers, Kathryn N. Devlin, Boting Ning, Yulin Liu, Ben Wasserman, Joseph M. Massaro, Melissa Lamar, Catherine C. Price, Rod Swenson, Randall Davis, Dana L. Penney, Rhoda Au, David J. Libon

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1611-1620
Number of pages10
JournalJournal of Alzheimer's Disease
Issue number4
StatePublished - 2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • General Neuroscience
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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