A Normative Study of the Trail Making Test-Black and White in the Korean Population.

Objective: Although the Trail Making Test (TMT) is widely used to identify cognitive dysfunction, it has limited utility in cross-cultural contexts due to the use of the English alphabet in a subset of the test. The TMT-Black and White (TMT-B&W) is a newly developed version of the TMT that uses only black and white circles to overcome performance biases among non-English-speaking and illiterate older individuals. The objective of this study was to provide initial normative data for the TMT-B&W from the Korean population and investigate the influence of age, sex, and education level on the time taken to complete the test.

Methods: We recruited 1012 participants (430 men and 582 women) aged 19 to 90 in the community settings including a Welfare Center for the Elderly. TMT-B&W tests were conducted, and the time to completion of the test was measured. Scaled scores (M = 10, SD = 3) were calculated and multiple regression analyses were conducted to establish regression based normative T-scores (M = 50, SD = 10) for the TMT-B&W part A and B.

Results: Age, education level, and sex significantly predicted TMT-B&W Part A and Part B performance. The regression models explained 52.6% of the variance for Part A and 69.6% for Part B. Demographically adjusted T-scores were developed, providing standardized normative data for clinical interpretation.

Conclusion: This study provided normative data for the TMT-B&W in the Korean population. This new version of the TMT has the potential to be employed in cross-cultural contexts without language barriers, although further validation across diverse populations is needed.