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Related Experiment Video

Updated: Feb 14, 2026

Traditional Trail Making Test Modified into Brand-new Assessment Tools: Digital and Walking Trail Making Test
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Errors versus speed on the trail making test: Relevance to driving performance.

Haley Duncanson1, Ann M Hollis2, Margaret G O'Connor1

  • 1Cognitive Neurology Unit, Beth Israel Deaconess Medical Center, United States; Harvard Medical School, United States.

Accident; Analysis and Prevention
|February 7, 2018
PubMed
Summary
This summary is machine-generated.

Trail Making Test (TMT) speed, not errors, predicts driving safety in older adults. Specific TMT A and TMT B cut-off times help identify drivers needing further assessment for cognitive impairment and driving fitness.

Keywords:
DementiaDrivingTrail making test

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Area of Science:

  • Neuroscience
  • Gerontology
  • Traffic Safety

Background:

  • Trail Making Test (TMT) speed is linked to driving safety, but optimal cut-off scores remain debated.
  • Older drivers are a focus for driving safety research due to age-related cognitive changes.

Purpose of the Study:

  • To determine optimal cut-off scores for TMT A and TMT B speed to predict driving impairment in older adults.
  • To evaluate the utility of TMT error scores in assessing driving fitness.

Main Methods:

  • Retrospective analysis of 373 drivers aged 65+ referred for driving evaluations.
  • Utilized TMT Parts A & B, Folstein Mini Mental Status Examination, and Washington University Road Test.
  • Compared drivers with and without Cognitive Impairment (CI).

Main Results:

  • For drivers with Cognitive Impairment (CI), TMT A speed > 46s predicted road test failure; TMT B speed was not sensitive.
  • For drivers without Cognitive Impairment (NCI), TMT B speed > 131s predicted driving impairment; TMT A speed was not sensitive.
  • TMT error scores did not predict driving fitness in either group.

Conclusions:

  • TMT speed, particularly TMT A for CI and TMT B for NCI groups, is a valuable predictor of driving performance.
  • Error rates on the TMT are not useful for determining driving fitness.
  • Healthcare providers should consider pre-existing cognitive status when interpreting TMT results for driving safety assessments.