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Community-based reference data and regression-based standard scores for interpreting Modified Tinkertoy Test

Yasuhisa Nakamura¹, Reiko Miyamoto², Akihiro Koreki³

¹Department of Rehabilitation, Faculty of Health Sciences, Nihon Fukushi University, Japan.

Applied Neuropsychology. Adult

|May 8, 2026

Summary

This study established reference data for the Modified Tinkertoy Test (m-TTT) in Japanese adults aged 20-59. Education, not age or sex, significantly influenced performance, providing a framework for interpreting this neuropsychological assessment.

Keywords:

Executive functioning Japanese adults Modified Tinkertoy Test This study was an observational cross-sectional normative study and was not prospectively registered because it did not meet the definition of a clinical trial neuropsychological assessment reference data

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Area of Science:

Neuropsychology
Cognitive Assessment
Psychometrics

Background:

The Modified Tinkertoy Test (m-TTT) is a performance-based assessment measuring executive functions in open-ended tasks.
Limited demographic reference data exists for the m-TTT in Japanese adults.
This study addresses the need for normative data in this population.

Purpose of the Study:

To develop preliminary community-based reference data for the m-TTT in Japanese adults aged 20-59 years.
To derive regression-based standard scores accounting for age, sex, and education.
To provide a framework for interpreting m-TTT performance in this demographic.

Main Methods:

124 Japanese adults (20-59 years) were assessed using the m-TTT.
Participants were stratified by age decade and sex.
Analysis of covariance adjusted for years of education; regression-based z and standard scores were calculated.

Main Results:

Years of education was significantly associated with m-TTT scores after adjustment.
Age decade, sex, and their interaction were not significant predictors of m-TTT performance.
The education-adjusted model explained a small proportion of score variance (R² = .034).

Conclusions:

Preliminary reference data and standard scores for the m-TTT in Japanese adults (20-59 years) were established.
These scores serve as reference indices, emphasizing the influence of education.
The findings offer a valuable framework for neuropsychological evaluations in this population.