Validity and reliability of the “trail making peg” test as a performance measurement for evaluating the cognitive function

Abstract

Aim: To investigate the validity and reliability of a novel performance test, called the “Trail Making Peg”（TMP) test, for evaluating the cognitive function. Methods: We recruited 632 community-dwelling older adults (mean age: 73.3 ± 5.2 years) as subjects for the assessment of the validity of the test and 319 adults (mean age: 73.1±5.2 years) as subjects for the assessment of reliability. Five cognitive tests (5- Cog) were used to evaluate the cognitive function, and the degree of cognitive decline was delineated for subjects scoring below 1SD from the mean 5-Cog score. A receiver operating characteristic analysis was employed to calculate the cut-off point. Results: There were no sex differences in the TMP scores (P = 0.951)，and the TMP and 5-Cog scores were found to correlate significantly (r =0.63) with each other. The Trail Making Peg test demonstrated an area under the curve of 0.855 for discriminat¬ing between non-cognitive decline and cognitive decline. At this cutoff point, the sensitivity was 85% and the specificity was 69%. The intraclass correlation coefficient of the TMP was 0.746. Conclusions: The TMP exhibits sufficient validity and reliability. Our results suggest that TMP is a useful screening test for detecting cognitive decline.