Trail Making Test: normative data for Turkish elderly population by age, sex and education

Abstract

Objective: Trail Making Test (TMT) is a neuropsychological test, which has parts A and B that can precisely measure executive functions, like complex visual-motor conceptual screening, planning, organization, abstract thinking and response inhibition. The main purpose of this study is to standardize TMT for Turkish adults and/or elderly population. This study primarily consists of two main parts; norm determination study and reliability/validity studies, respectively.

Methods: The standardization study was carried on 484 participants (238 female and 246 male). Participants at the age of 50 years and older were selected from a pool of people employed in or retired from governmental and/or private institutions. The research design of this study involves the following variables mainly; age (7 subgroups), sex (2 subgroups) and education (3 subgroups).

Results: Age, sex and education variables have significant influence on eight different kinds of TMT scores. Statistical analysis by ANOVA revealed a major effect of age (p<0.001) and education (p<0.001) on time spent in Part A or B, or time difference between Parts B and A, or sum of Parts A and B. Similarly, influence of sex (p<0.05) on time spent on Part A or B, or sum of Parts A and B was shown to be significant. Kruskal-Wallis Test was performed and chi-square (chi(2)) values revealed that, correction scores for Part A and B were found to be influenced by age groups (p<0.001). Test-retest reliability and inter-rater reliability coefficients for time scores of Parts A and B were estimated as 0.78, 0.99 and 0.73, 0.93, respectively.

Conclusion: This study provides normative data for a psychometric tool that reliably measures the executive functions in Turkish elderly population at the age of 50 and over.