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Zeitschrift für Alzheimer-Krankheit und Parkinsonismus

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A Comparison of Three types of Trail Making Test in the Korean Elderly: Higher Completion Rate of Trail Making Test-Black and White for Mild Cognitive Impairment

Karyeong Kim, Jae-Won Jang, Min Jae Baek and Sang Yun Kim

Objective: A Korean version of Trail Making Test (TMT) led to reduced clinical use in Korea because of lower completion rate. The current study examines multiple TMT versions in effort to identify which type might accurately detect cognitive decline with higher completion rate.

Methods: Three versions of TMT including the original TMT, TMT-Korean Letter (TMT-K), and TMT-Black and White (TMT-B&W) were utilized. A total of 62 participants were included, comprised of 30 cognitively normal controls (NC) and 32 mild cognitive impairment (MCI). Three TMT versions were administered to subjects with other neuropsychological tests.

Results: TMT-B&W completion time as well as that of Original TMT and TMT-K was successful in distinguishing MCI from NC adjusted for age, sex and educational level. TMT-B&W also showed a high correlation with other neuropsychological tests that represent frontal executive function. Regarding completion rate in MCI patients, Original TMT and TMT-K were not successfully completed (62% and 60.6%, respectively) compared with TMT-B&W (90.1%).

Conclusion: As TMT-B&W showed higher completion rate than others and revealed significant correlation with frontal executive function, this culture-fair measure can vitalize TMT task with increased applicability in Korean elderly adults who are unfamiliar with the sequence of English or Korean alphabet.