Texas Card Sorting Test: a Brief Test of Executive Functioning with Age-Adjusted Norms and External Validation
Laura H Lacritz1,2, Alyssa N Kaser1, Francisco Argueta-Ortiz1
1Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA.
Summary
The Texas Card Sorting Test (TCST) effectively measures executive functioning in aging adults. It accurately distinguishes between normal aging and dementia, providing valuable normative data for clinical interpretation.
Area of Science:
- Neuroscience
- Psychology
- Gerontology
Background:
- Executive functions are crucial for cognitive health in aging.
- The Texas Card Sorting Test (TCST) is a brief measure of executive functioning.
- Existing measures often have limitations such as length or language demands.
Purpose of the Study:
- To generate age-adjusted normative data for the TCST in healthy older adults.
- To assess the TCST's sensitivity, specificity, and convergent validity.
- To compare TCST performance between normal controls (NC) and Alzheimer's disease clinical syndrome (ADCS) participants.
Main Methods:
- Collected TCST data from 164 NC and 92 ADCS participants.
- Derived age-adjusted normative data and examined test characteristics.
- Assessed correlations with other cognitive measures and performed receiver operating characteristic (ROC) analysis.
Main Results:
- TCST Logical Sorts (LS) correlated significantly with age and education.
- Significant differences in TCST performance were found between NC and ADCS groups (p < .001).
- ROC analysis showed an AUC of 0.912, with 75% sensitivity and 73% specificity for distinguishing NC from ADCS.
Conclusions:
- The TCST is a valid and feasible brief measure of executive functioning.
- It accurately discriminates between normal aging and dementia.
- Provided normative data will improve TCST interpretation in clinical settings.
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