Assessing learning potential in elderly stroke patients: The validity of the dynamic Clock Drawing Task in comparison with the dynamic Wisconsin Card Sorting Test.

Abstract

Currently, there is no valid and feasible dynamic test available for assessing learning potential in elderly stroke patients. We designed a dynamic version of the Clock Drawing Task (dCDT) which we compared to the dynamic Wisconsin Card Sorting Test (dWCST). The dWCST has shown adequate validity in adult patients with brain injury but has a long administration time. Participants were 47 stroke patients admitted to a geriatric rehabilitation unit. All participants completed the dCDT, the mean administration time was 7 min. 90.7% of the participants were able to complete the dWCST, the mean administration time was 36 min. The numerical learning potential indices of the dCDT were not significantly correlated. Based on the dCDT, 70.2% of the participants were classified as high achiever, 10.6% as strong learner, 19.2% as poor learner, and none as decliner. The numerical learning potential indices of the dWCST correlated significantly. Based on the dWCST, 5.3% of the participants were classified as high achiever, 42.1% as strong learner, 50% as poor learner, and 2.6% as decliner. The learning potential indices of the dCDT and those of the dWCST were not significantly correlated, indicating poor convergent validity of the dCDT. The results provide no clear support for the use of the dCDT in elderly stroke patients. The dWCST does show adequate validity and feasibility in the elderly stroke population, despite longer administration time. Future research should focus on examining the validity of the dCDT in a larger sample as well as examining the predictive validity of the dWCST.