Regression-based normative data and equivalent scores for Trail Making Test (TMT): an updated Italian normative study

Objectives The Trail Making Test (TMT) is widely used to assess psychomotor speed and attentional set-shifting. Since the regression-based norms and equivalent scores (ESs) for the TMT Italian version trace back to more than 20years ago, we aimed at providing updated normative data for basic (Part A and Part B) and derived (Score B-A and Score B/A) TMT scores collected in a larger sample with an extended age range. Methods Three hundred fifty-five Italian volunteers stratified for sex (166 men), age decades (age range 20-90years), and educational level (from primary school to university) completed the TMT and the Montreal Cognitive Assessment (MoCA). Results Multiple linear regression analyses revealed that age and educational level significantly influenced performances on basic and derived TMT scores except for B/A, which was associated only with the educational level. From the derived linear equations, correction grids for basic and derived TMT raw scores were developed. Inferential cutoff scores, estimated using a non-parametric technique, and ES were computed. Basic and derived TMT scores showed a good test-retest reliability (all r(s) >= 0.50); Part B (r(s)=-0.48, p<0.001) and Score B-A (r(s)=-0.49, p<0.001) were moderately associated with MoCA total score. Conclusions This study confirms the association of basic and derived TMT raw scores with sociodemographic variables and provides updated correction grids and ES for assessing the attentional/executive functions in clinical and research fields.