Development and Validation of a Chinese Electronic Trail Making Test for Executive Functions Evaluation: A Pilot...

Area of Science:

• Neuroscience
• Cognitive Psychology
• Digital Health

Background:

• The Trail Making Test (TMT) is crucial for evaluating executive functions.
• A culturally adapted, reliable electronic TMT (eTMT) for Chinese speakers was lacking.
• Existing paper-based TMT (pTMT) has limitations in data collection.

Purpose of the Study:

• To develop and evaluate a culturally adapted eTMT for Chinese-speaking populations.
• To assess the test-retest reliability of the novel eTMT.
• To explore the potential of eTMT for comprehensive executive function assessment.

Main Methods:

• Developed a culturally adapted eTMT using Chinese Zodiac symbols and characters.
• Recruited 34 older adults for a pilot study.
• Administered the eTMT and compared results with the paper version, analyzing completion time, response times, movement patterns, and error rates.

Main Results:

• The eTMT demonstrated strong test-retest reliability (ICC and Cronbach's α ≈ 0.7-0.8, p < 0.000).
• eTMT scores correlated well with the paper version (r ≈ 0.5-0.7, p < 0.000).
• eTMT captured additional metrics beyond completion time, including response times, movement patterns, and error rates.

Conclusions:

• The culturally adapted eTMT is a reliable tool for assessing executive functions in Chinese speakers.
• The eTMT provides richer, multi-dimensional data compared to the pTMT.
• This digital format supports flexible, eco-friendly, and data-rich assessments for clinical and community settings.