The clock drawing test (CDT) in the digital era: Underperformance of Generation Z adults

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences Pub Date : 2024-11-05 DOI:10.1016/j.jns.2024.123289

Guy Vishnevsky , Tali Fisher , Polina Specktor

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Abstract

Background and objectives

The clock drawing test (CDT) is a widely recognized neurocognitive test for executive and visuospatial functions. However, no normative data exist for Generation Z young adults (born on or after 1997). The widespread use of digital displays among this generation may impair performance on the analog CDT.

Methods

Young Generation Z adults with at least 12 years of education, who were evaluated at the Israel Defense Forces (IDF) outpatient neurology clinic between 2021 and 2022, completed a CDT using the Manos-Wu method and drew a digital clock. Patients with possible cognitive impairment were excluded.

Results

Three hundred Generation Z patients were recruited, with a mean age of 19.7 ± 1.2 years. 171 (57.0 %) were female. Mean CDT score was 8.1 ± 2.5 out of 10 (Manos & Wu). A lower CDT score was associated with younger age (p = 0.031). No association was found with chief complaint, presence of ADHD diagnosis, gender, or postsecondary education. Digital clock drawing (4/4 digits) was successful in 100 % of patients.

Discussion

Generation Z adults demonstrate lower CDT scores than previously reported for older generations. The CDT may require revision to maintain its specificity for this population. Developing an alternative, digital-based tool for cognitive screening in young generations could be advisable.

Abstract Image

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数字时代的时钟画图测试（CDT）：Z世代成年人表现不佳。

背景和目的：时钟画图测验（CDT）是一项广受认可的神经认知测验，用于测试执行和视觉空间功能。然而，目前还没有针对 Z 世代年轻人（1997 年或之后出生）的常模数据。这一代人广泛使用数字显示器可能会影响模拟 CDT 的成绩：方法：2021 年至 2022 年期间在以色列国防军（IDF）神经病学门诊接受评估的至少受过 12 年教育的 Z 世代年轻成人使用马诺斯-吴法完成 CDT，并绘制数字时钟。可能存在认知障碍的患者被排除在外：共招募了 300 名 Z 世代患者，平均年龄为（19.7 ± 1.2）岁。171人（57.0%）为女性。CDT 平均分为 8.1 ± 2.5（满分 10 分）（Manos 和 Wu）。CDT 分数较低与年龄较小有关（p = 0.031）。与主诉、多动症诊断、性别或中学后教育程度均无关联。100%的患者都能成功绘制数字时钟（4/4 位）：讨论：Z 世代成年人的 CDT 分数低于之前报道的上一代成年人。CDT 可能需要修改，以保持其对这一人群的特异性。为年轻一代的认知筛查开发一种基于数字的替代工具可能是明智之举。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Neurological Sciences 医学-临床神经学

CiteScore

7.60

自引率

2.30%

发文量

313

审稿时长

22 days

期刊介绍： The Journal of the Neurological Sciences provides a medium for the prompt publication of original articles in neurology and neuroscience from around the world. JNS places special emphasis on articles that: 1) provide guidance to clinicians around the world (Best Practices, Global Neurology); 2) report cutting-edge science related to neurology (Basic and Translational Sciences); 3) educate readers about relevant and practical clinical outcomes in neurology (Outcomes Research); and 4) summarize or editorialize the current state of the literature (Reviews, Commentaries, and Editorials). JNS accepts most types of manuscripts for consideration including original research papers, short communications, reviews, book reviews, letters to the Editor, opinions and editorials. Topics considered will be from neurology-related fields that are of interest to practicing physicians around the world. Examples include neuromuscular diseases, demyelination, atrophies, dementia, neoplasms, infections, epilepsies, disturbances of consciousness, stroke and cerebral circulation, growth and development, plasticity and intermediary metabolism.