Dement Neurocogn Disord.  2016 Dec;15(4):135-141. 10.12779/dnd.2016.15.4.135.

A Comparison of Five Types of Trail Making Test in Korean Elderly

Affiliations
  • 1Department of Neurology, Kangwon National University Hospital, Chuncheon, Korea.
  • 2Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Korea. neuroksy@snu.ac.kr
  • 3Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND AND PURPOSE
Previously developed Korean versions of the Trail Making Test (TMT) that replaced the English in part B, has been unsuccessful in Korea. The current study identifies the type of TMT tasks from the among multiple TMT versions, which practically and accurately detects the stage of cognitive decline.
METHODS
We applied five TMT versions, which include the original TMT, TMT-Korean letter (TMT-KL), TMT-Korean consonant (TMT-KC), TMT-black and white (TMT-B&W), and TMT-square and circle (TMT-S&C). A total of 168 participants were enrolled: 42 cognitively normal controls (NC), 72 patients with mild cognitive impairment (MCI), and 54 patients with Alzheimer's disease (AD). Two sets of TMT (set "A" including TMT, TMT-KL and TMT-B&W, and set "B" including TMT, TMT-KC, and TMT-S&C) were randomly administered to subjects within the contact of a fixed neuropsychological battery.
RESULTS
The completion times of TMT-B and TMT-B&W successfully distinguished NC from MCI and AD. TMT-B&W also showed a high correlation with other neuropsychological tests, and correlated well with the original TMT. The other TMT were frequently not successfully completed, nor could they differentiate the clinical groups.
CONCLUSIONS
Among the five TMT tasks, the original TMT and the TMT-B&W appeared to be most sensitive to the degree of cognitive impairment. TMT-B&W showed a pattern consistent with the original TMT; thus, this measure may be optimal in Korean older adults, where familiarity with the English alphabet is questionable.

Keyword

Trail Making Test; frontal lobe function test; mild cognitive impairment

MeSH Terms

Adult
Aged*
Alzheimer Disease
Cognition Disorders
Humans
Korea
Mild Cognitive Impairment
Neuropsychological Tests
Recognition (Psychology)
Trail Making Test*

Figure

  • Fig. 1 Two Trail Making Sets. TMT: Trail Making Test, TMT-A: A form of TMT, TMT-B: B form of TMT, TMT-B&W-A: A form of black and white TMT, TMT-B&W-B: B form of black and white TMT, TMT-KC: Korean consonant version of TMT, TMT-KL: Korean letter version of TMT, TMT-S&C-A: A form of square and circle TMT, TMT-S&C-B: B form of square and circle TMT.


Reference

1. Lezak MD, Howieson DB, Loring DW. Neuropsychological Assessment. 4th ed. New York: Oxford University Press;2004. p. 317–374.
2. Spreen O, Strauss E. A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. 2nd ed. New York: Oxford University Press;1998.
3. Kraybill ML, Larson EB, Tsuang DW, Teri L, McCormick WC, Bowen JD, et al. Cognitive differences in dementia patients with autopsy-verified AD, Lewy body pathology, or both. Neurology. 2005; 64:2069–2073.
Article
4. Walker AJ, Meares S, Sachdev PS, Brodaty H. The differentiation of mild frontotemporal dementia from Alzheimer’s disease and healthy aging by neuropsychological tests. Int Psychogeriatr. 2005; 17:57–68.
Article
5. Crowe SF. The differential contribution of mental tracking, cognitive flexibility, visual search, and motor speed to performance on parts A and B of the Trail Making Test. J Clin Psychol. 1998; 54:585–591.
Article
6. Anderson CV, Bigler ED, Blatter DD. Frontal lobe lesions, diffuse damage, and neuropsychological functioning in traumatic brain-injured patients. J Clin Exp Neuropsychol. 1995; 17:900–908.
Article
7. Stuss DT, Bisschop SM, Alexander MP, Levine B, Katz D, Izukawa D. The Trail Making Test: a study in focal lesion patients. Psychol Assess. 2001; 13:230–239.
Article
8. Seo EH, Lee DY, Kim KW, Lee JH, Jhoo JH, Youn JC, et al. A normative study of the Trail Making Test in Korean elders. Int J Geriatr Psychiatry. 2006; 21:844–852.
Article
9. Yi HS, Chin JH, Lee BH, Kang YW, Na DL. Development and validation of Korean version of Trail Making Test for elderly persons. Dement Neurocogn Disord. 2007; 6:54–66.
10. Park JS, Kang YW, Yi HS, Kim YJ, Ma HI, Lee BC. Usefulness of the Korean Trail Making Test for the elderly (K-TMT-e) in detecting the frontal lobe dysfunction. Dement Neurocogn Disord. 2007; 6:12–17.
11. Kang Y, Na DL, Hahn SH. A validity study on the Korean Mini-Mental State Examination (K-MMSE) in dementia patients. J Korean Neurol Assoc. 1997; 15:300–308.
12. Kang SJ, Choi SH, Lee BH, Lee MA, Kwon JC, Na DL, et al. The reliability and validity of the Korean Instrumental Activities of Daily Living (K-IADL). J Korean Neurol Assoc. 2002; 20:8–14.
13. Christensen KJ, Multhaup KS, Nordstrom SK, Voss KA. A cognitive battery for dementia: development and measurement characteristics. J Consult Clin Psychol. 1991; 3:168–174.
Article
14. Chin JH, Oh KJ, Seo SW, Shin HY, Na DL. The characteristics and subtypes of subjective memory impairment in older adults. Dement Neurocogn Disord. 2010; 9:115–121.
15. Marshall GA, Fairbanks LA, Tekin S, Vinters HV, Cummings JL. Neuropathologic correlates of activities of daily living in Alzheimer disease. Alzheimer Dis Assoc Disord. 2006; 20:56–59.
Article
16. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med. 2004; 256:183–194.
Article
17. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology. 1984; 34:939–944.
Article
18. O’Bryant SE, Waring SC, Cullum CM, Hall J, Lacritz L, Massman PJ, et al. Staging dementia using Clinical Dementia Rating Scale Sum of Boxes scores: a Texas Alzheimer’s research consortium study. Arch Neurol. 2008; 65:1091–1095.
Article
19. O’Bryant SE, Lacritz LH, Hall J, Waring SC, Chan W, Khodr ZG, et al. Validation of the new interpretive guidelines for the Clinical Dementia Rating scale Sum of Boxes score in the national Alzheimer’s coordinating center database. Arch Neurol. 2010; 67:746–749.
Article
20. Ashendorf L, Jefferson AL, O’Connor MK, Chaisson C, Green RC, Stern RA. Trail Making Test errors in normal aging, mild cognitive impairment, and dementia. Arch Clin Neuropsychol. 2008; 23:129–137.
Article
21. Reitan RM. The relation of the Trail Making Test to organic brain damage. J Consult Psychol. 1955; 19:393–394.
Article
22. Fossum B, Holmberg H, Reinvang I. Spatial and symbolic factors in performance on the Trail Making Test. Neuropsychology. 1992; 6:71–75.
Article
23. Rossini ED, Karl MA. The Trail Making Test A and B: a technical note on structural nonequivalence. Percept Mot Skills. 1994; 78:625–626.
Article
24. Arnett JA, Labovitz SS. Effect of physical layout in performance of the Trail Making Test. Psychol Assess. 1995; 7:220–221.
Article
25. Gaudino EA, Geisler MW, Squires NK. Construct validity in the Trail Making Test: what makes Part B harder? J Clin Exp Neuropsychol. 1995; 17:529–535.
Article
26. Ivnik RJ, Malec JF, Smith GE, Tangalos EG, Petersen RC. Neuropsychological Tests’ norms above age 55: COWAT, BNT, MAE token, WRAT-R reading, AMNART, STROOP, TMT, and JLO. Clin Neuropsychol. 1996; 10:262–278.
Article
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