Validation of the DCTclock drawing task as a cognitive screening tool for prodromal Alzheimers disease in the Framingham Heart Study

Brown University, Providence RI

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Abstract

Abstract. The diagnosis of probable Alzheimer’s disease (AD) has traditionally depended on fluid biomarkers and neuroimaging. However, these tests are often invasive, expensive, and generally available only in specialty clinics. Common neuropsychological tests used to screen for dementia (e.g., Mini-Mental State Examination) are not sensitive enough to detect early cognitive changes that can predict the emergence of prodromal AD. The DCTclockTM is an FDA approved digital neuropsychological test with the potential to be deployed in primary care and clinical trials research as a non-invasive and cost-effective screening tool for detecting the earliest stages of AD. The DCTclockTM can be easily administered by any healthcare professional and uses cutting-edge methods to capture nuanced neuropsychological behavior. Initial studies suggest that the DCTclockTM has high sensitivity to predict cortical amyloid (Aß) deposition and parietal hypometabolism on neuroimaging, suggesting that it could serve as a surrogate for more invasive or costly biomarker testing. This project will validate the DCTclockTM in a large sample of older adults from the Framingham Heart Study (FHS), using cross sectional and longitudinal approaches with the goals of determining: (1) the DCTclock’s ability to distinguishing mild cognitive impairment (MCI) from normal aging relative to existing cognitive screening measures, (2) its associations with genetic biomarkers of AD and neuroimaging measures of AD pathology, including MRI metrics and brain Aß levels on a PET scan. DCTclockTM drawing data has been collected in the FHS since 2011 from over 1,600 older adults without dementia, making it an ideal database for this validation study.