title: The Shape Trail Test: application of a new variant of the Trail making test.
abstract: OBJECTIVE
  The Trail making test (TMT) is culture-loaded because of reliance on the Latin alphabet, limiting its application in Eastern populations. The Shape Trail Test (STT) has been developed as a new variant. This study is to examine the applicability of the STT in a senile Chinese population and to evaluate its potential advantages and disadvantages.
  
  
  METHODS
  A total of 2470 participants were recruited, including 1151 cognitively normal control (NC), 898 amnestic mild cognitive impairment (aMCI), and 421 mild Alzheimer disease (AD) patients. Besides the STT, the Mini mental state examination and a comprehensive neuropsychological battery involving memory, language, attention, executive function and visuospatial ability were administered to all the participants. In a subgroup of 100 NC and 50 AD patients, both the STT and the Color Trail Test (CTT) were performed.
  
  
  RESULTS
  In NC, the time consumed for Part A and B (STT-A and STT-B) significantly correlated with age and negatively correlated with education (p<0.01). STT-A and B significantly differed among the AD, aMCI and NC. The number that successfully connected within one minute in Part B (STT-B-1 min) correlated well with STT-B (r = 0.71, p<0.01) and distinguished well among NC, aMCI and AD. In the receiver operating characteristic curve analysis, the AUCs (area under the curve) for STT-A, STT-B, and STT-B-1min in identifying AD were 0.698, 0.694 and 0.709, respectively. The STT correlated with the CTT, but the time for completion was longer.
  
  
  CONCLUSIONS
  The TMT is a sensitive test of visual search and sequencing. The STT is a meaningful attempt to develop a "culture-fair" variant of the TMT in addition to the CTT.
authors: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors: Qianhua
authors: Q
authors: Zhao
authors: Qihao
authors: Q
authors: Guo
authors: Fang
authors: F
authors: Li
authors: Yan
authors: Y
authors: Zhou
authors: Bei
authors: B
authors: Wang
authors: Zhen
authors: Z
authors: Hong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology*; D000647:Amnesia / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology*; D044466:Asian People; D001288:Attention; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology*; D004522:Educational Status; D056344:Executive Function; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008568:Memory; D008875:Middle Aged; D012372:ROC Curve; D011930:Reaction Time; D012720:Severity of Illness Index; D013028:Space Perception; D014145:Trail Making Test / Q000706:statistics & numerical data*; D014796:Visual Perception