Rendimientos Neuropsicológicos del Test del Reloj Versión Cacho en Población Adulta

Abstract

Introduction: As the population ages, the impact of neurodegenerative diseases will continue to increase, underscoring the importance of accurate and effective assessment tools for early detection and treatment. The Cacho Version Clock Drawing Test is a widely used tool in neuropsychological assessment. However, the availability of specific normative data for this version is limited, which hinders its accurate application in diverse populations. Objective: To analyze the neuropsychological performances of the Cacho Version Clock Drawing Test in a group of participants older than 55 years without subjective memory complaints (SMCs). Methods: The total sample of this study is composed of 498 participants. The mean age of the participants without neurocognitive disorder is 74,47 ± 11,69 years, and an age range from 55 to 97 years. Each participant underwent a face-to-face assessment session lasting approximately 45 minutes, during which the following screening protocol was administered: Sociodemographic data collection, Cacho Version Clock Test, Cognitive Functions Rapid Assessment Test, Trail Making Test and Cognitive Reserve Questionnaire. Results: A statistically significant negative correlation was found between age and performance in the CDT in both on command (CDTcm) and copy (CDTcp) modalities, with correlation coefficients of r=-0,603 and r=-0,571 respectively (p=0) for both. Similarly, significant differences appeared between sex and performance in the CDTcm and CDTcp tests, with values of p<0,00 and r=-0,43, respectively. For the CDTcm, significant correlations were found between the sphere and the hands (r = 0,117), as well as between the hands and the numbers (r = 0,541). For the CDTcp , the significant correlations were between the sphere and the hands (r = 0,158) and between the hands and the numbers (r = 0,399). The area under the curve (AUC) for the CDTcm was 0,871 and for the CDTcp was 0,783, indicating good discriminative ability. The optimal cut-off points were 7,5 for CDTcm and 8,5 for CDTcp, with sensitivities of 0,798 and 0,794, respectively. The HJ-Biplot analysis showed a cumulative variability of 49,947%, and together with the regression analyses confirmed the importance of the level of studies as the most significant predictor of the execution of the Cacho Version Clock Drawing Test. Conclusions: Both the CDTcm and the CDTcp are useful tools for the assessment of cognitive functions. Due to the functions involved for their correct execution, the discriminative capacity of the CDTcm is superior to that of the CDTcp. The cut-off points established for both tests provide a clear guide for the interpretation of the results, and the trends observed in the scores by age range underline the importance of considering age when assessing cognitive abilities.