Detecting cognitive impairment in individuals at risk for cardiovascular disease: the "Clock-in-the-Box" screening test

Objective The purpose of this study was to evaluate the performance on the Clock‐in‐the‐Box (CIB), a screening measure for cognitive function, relative to neuropsychological testing in an older population with cardiovascular risk. Methods A prospective cohort of older patients (>50 years) with cardiovascular risk was recruited to perform the CIB and complete a brief neuropsychological battery consisting of Trailmaking tests, the Hopkins Verbal Learning Test (HVLT), and fluency tasks. Performance on the CIB was scored according to standard criteria (range 0–8, 0–worst). The performance on the total CIB, working memory subscale (CIB–WM), and planning/organization (COB–PO) was compared to neuropsychological measures. Results The cohort (n = 127) was older (age 67 ± 7 years) and diverse with 33% female (n = 42) and 42% non‐white race (n = 53). Cardiac risk factors were prevalent: hypertension (83%), hyperlipidemia (74%), overweight (84%), diabetes (48%), prior cardiac disease (39%), and smoking (11%). The CIB (mean 6.5 ± 1.3) took 84 ± 21 s on average to complete and had good inter‐rater reliability (κ = 0.809, p