ArticleNeurology2021
Association of Digital Clock Drawing With PET Amyloid and Tau Pathology in Normal Older Adults.
Article in Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
58 citing papers in PubMed, 2 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Validation status of cognitive digital assessments by the FDA BEST framework and context of use in preclinical AD studies: A systematic review.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Pooled it
- Digital Clock Drawing as an Alzheimer's Disease Susceptibility Biomarker: Associations with Genetic Risk Score and APOE in Older Adults.The journal of prevention of Alzheimer's disease · 2024Pooled it
- Digital maze test reveals cognitive performance patterns associated with amyloid-β and tau.Neuropsychology · 2026Article
- The myth of digital biomarkers in Alzheimer's disease: how to make them a reality.Current opinion in psychiatry · 2026Review
- Computer Vision Scoring of Figure Copy and Recall.medRxiv : the preprint server for health sciences · 2026Article
- Cognitive Trajectories from Preclinical Alzheimer's Disease to Dementia.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Diagnostic accuracy of digital clock drawing test for Alzheimer disease and mild cognitive impairment.NPJ digital medicine · 2026Article
- Predicting cognitive impairment using novel functional features of spatial proximity and circularity in the digital clock drawing test.medRxiv : the preprint server for health sciences · 2026Article
- Streamlining Eligibility Assessment for Alzheimer's Disease-Modifying Therapies: Prediction of MMSE Scores Using the Digital Clock and Recall.medRxiv : the preprint server for health sciences · 2026Article
- Higher Amyloid and Tau Burden Is Associated With Faster Decline on a Digital Cognitive Test.Annals of clinical and translational neurology · 2026Article
- Streamlining eligibility assessment for Alzheimer's disease-modifying therapies: Prediction of MMSE scores using the digital clock and recall.Frontiers in digital health · 2026Article
- The clock drawing test as a screening tool for detecting cognitive decline: an analysis in adults and elderly people from Natal (RN).Frontiers in human neuroscience · 2026Article
- Identifying early changes in imaging, plasma, and digital cognitive biomarkers that correspond to Alzheimer's disease pathology in the presence of autopsy-confirmed co-pathologies.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Digital clock assessment in South Asian setting: pilot study.NPJ dementia · 2026Article
- Concurrent detection of cognitive impairment and amyloid positivity with a multimodal machine learning-enabled digital cognitive assessment.Alzheimer's research & therapy · 2025Article
- Detecting Alzheimer's disease using digital virtual reality cognitive tests.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Performance of Older Adults on the Digital Clock and Recall Test Compared to the Montreal Cognitive Assessment in Primary Care Settings.Journal of general internal medicine · 2025Article
- Digital Clock Assessment in South Asian Setting: Pilot study.Research square · 2025Article
- Feasibility and Acceptability of Implementing a Digital Cognitive Assessment for Alzheimer Disease and Related Dementias in Primary Care.Annals of family medicine · 2025Article
- A scoping review of remote and unsupervised digital cognitive assessments in preclinical Alzheimer's disease.NPJ digital medicine · 2025Article
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Authors and funding
8 authors at 1 institution in 2 countries.
Funding
Abstract
objectiveTo determine whether a digital clock-drawing test, DCTclock, improves upon standard cognitive assessments for discriminating diagnostic groups and for detecting biomarker evidence of amyloid and tau pathology in clinically normal older adults (CN).
methodsParticipants from the Harvard Aging Brain Study and the PET laboratory at Massachusetts General Hospital were recruited to undergo the DCTclock, standard neuropsychological assessments including the Preclinical Alzheimer Cognitive Composite (PACC), and amyloid/tau PET imaging. Receiver operating curve analyses were used to assess diagnostic and biomarker discriminability. Logistic regression and partial correlations were used to assess DCTclock performance in relation to PACC and PET biomarkers.
resultsA total of 300 participants were studied. Among the 264 CN participants, 143 had amyloid and tau PET imaging (Clinical Dementia Rating [CDR] 0, Mini-Mental State Examination [MMSE] 28.9 ± 1.2). An additional 36 participants with a diagnosis of mild cognitive impairment or early Alzheimer dementia (CDR 0.5, MMSE 25.2 ± 3.9) were added to assess diagnostic discriminability. DCTclock showed excellent discrimination between diagnostic groups (area under the receiver operating characteristic curve 0.86). Among CN participants with biomarkers, the DCTclock summary score and spatial reasoning subscores were associated with greater amyloid and tau burden and showed better discrimination (Cohen d = 0.76) between Aβ± groups than the PACC (d = 0.30).
conclusionDCTclock discriminates between diagnostic groups and improves upon traditional cognitive tests for detecting biomarkers of amyloid and tau pathology in CN older adults. The validation of such digitized measures has the potential of providing an efficient tool for detecting early cognitive changes along the AD trajectory. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that DCTclock results were associated with amyloid and tau burden in CN older adults.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.