SHB: Small: InteCog System: ClockReader+ and CogStim Game for Screening and Preventing Cognitive Impairment

与年龄相关的认知障碍，包括阿尔茨海默病，是美国最常见的疾病之一。通过延迟预防目前被认为是解决阿尔茨海默病和相关疾病（ADRD）的最佳途径。早期发现是至关重要的，因为筛查轻度认知障碍（MCI）患者可能会延缓其进展并阻止其发展。这项研究调查了技术在具有潜在轻度认知障碍风险因素的老年人和医疗从业人员（如神经科医生或神经心理学家）做出数据驱动的临床决策中的作用。时钟绘制测试是要求患者绘制显示特定时间的时钟，是痴呆症筛查中最简单和最常用的工具之一。目前的做法要求医生管理和评估每个单独的纸笔测试。它需要繁琐的工作，并且容易出现错误，不同临床医生之间的评分不一致。为了解决这些困难，该研究小组之前的工作已经产生了一个基于计算机的时钟绘图测试版本，该测试记录了患者在平板电脑上的徒手绘图，然后分析该绘图以寻找认知障碍的证据。目前的项目正在扩展以计算机为基础的系统，以获取与时钟绘图测试相关的额外数据。这些数据包括拉伸和暂停阶段的时间，以及拉伸期间施加的压力。这些数据可用于临床医生选择的几种不同评分标准下的评估图纸。通过数据分析和焦点小组讨论，正在评估新特征的临床效用，目标是进一步改进。

Age-related cognitive impairments, including Alzheimer's disease, are among the most common diseases in the United States. Prevention through delay is currently considered the best way to tackle Alzheimer's disease and related disorders (ADRD). Early detection is crucial, as screening individuals with Mild Cognitive Impairment (MCI) may delay its progression and prevent it from developing. This research investigates the role of technologies for senior citizens with potential MCI at-risk factors and for medical practitioners, such as neurologists or neuropsychologists, to make data-driven clinical decisions.The Clock Drawing Test, in which the patient is asked to draw a clock showing a certain time, is one of the easiest and most frequently used instruments for dementia screening. Current practice requires medical practitioners to administer and assess each individual paper-and-pencil test. It requires tedious effort and is prone to errors and inconsistent scoring among different clinicians. To address these difficulties, previous work by this research group has resulted in a computer-based version of the Clock Drawing Test that records a patient's freehand drawing on a tablet computer, then analyzes the drawing for evidence of cognitive imparment.The current project is extending the computer-based system to acquire additional data associated with the Clock Drawing Test. This data includes timing of drawing and pausing phases, and pressure applied during drawing. The data can be used in evaluating drawings under several different scoring critera that can be chosen by the clinician. Through analysis of data and focus group discussions, the clinical utility of the new features are being evaluated with a goal of further improvement.