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KMID : 1100220070060020054
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Dementia and Neurocognitive Disorders
2007 Volume.6 No. 2 p.54 ~ p.66
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Development & Validation of Korean Version of Trail Making Test for Elderly Persons
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Yi Han-Seung
Kang Yeon-Wook
Na Duk-Lyul
Chin Ju-Hee
Lee Byung-Hwa
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Abstract
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Background: The most commonly used version of Trail making test (TMT), Halstead-Reitan version, may not be applicable to most Korean elderly dementia patients not only because it contains English alphabets but also it may be too difficult. Thus we developed an easier form of TMT for Korean elderly (K-TMT-e) and conducted a validation study.
Methods: K-TMT-e was modified from Halstead-Reitan version such that 1) the number of circles was reduced to 15, 2) in part B, instead of English alphabets we used Korean letters representing days of the week, 3) the pattern and length of the total traces were controlled between part A and B. Time needed to complete part A (‘A’) and part B (‘B’) were recorded. If subjects could not complete each task in 5 min, the examiner terminated the task. K-TMT-e along with Korean mini-mental state examination (K-MMSE), controlled oral word association test (COWAT), and Korean color-word stroop test (K-CWST) were administered to 134 normal subjects and 38 patients with probable Alzheimer’s disease (26/38) or subcortical vascular dementia (12/38). For test-retest reliability, 20 subjects received K-TMT-e twice.
Results: All indices of K-TMT-e were worse in dementia groups compared to normal subjects (p<0.001). In addition A’, B’, B-A were significantly higher in CDR 0.5 patient group than normal individuals. The area under the receiver operating characteristic curve for ‘B’ was the largest among indices, while B-A was the most sensitive index to discriminate between dementia and normal. With respect to diagnosis of dementia, B’ (cutoff: 72.97 sec) had a sensitivity of 84.4% and a specificity of 80.2%, and B-A (cut-off: 41.69 sec) had a sensitivity of 87.5% and a specificity of 80.2%. All indices (A’, B’ and B-A) except for B/A showed correlations with K-MMSE, K-CWST and COWAT. Test-retest reliability was high (r= 0.997 for A’, r=0.998 for B’).
Conclusions: K-TMT-e had high test-retest reliability and is easy to administer to the elderly. It may be used as a tool for dementia screening in clinical setting.
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KEYWORD
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Trail making test, Dementia, Screening
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