DOI: 10.1002/alz.076928 ISSN: 1552-5260

A normative study of the Trail Making Test‐Black and White

Jeewon Suh, Min Jae Baek, Yeonwook Kang, SangYun Kim
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Geriatrics and Gerontology
  • Neurology (clinical)
  • Developmental Neuroscience
  • Health Policy
  • Epidemiology



The Trail Making Test (TMT) is a neuropsychological test to measure frontal and executive function. Although it is a widely used test in identifying dementia, TMT has limited utility in cross‐culture contexts because of the use of the English alphabet in a subset of the test. TMT‐Black and white (TMT‐B&W) is a newly developed version of TMT which uses only black and white circles to overcome the performance bias among non‐English speaking and illiterate elderly. The objective of this study is to provide the initial normative data of TMT B&W and investigate the influence of age, gender and education level on the time to complete the test.


The TMT‐B&W was administered to 1,012 cognitively normal participants (430 males and 582 females) from age 19 to 90 and the time in seconds taken to complete the test was measured.


Age, education level and gender were significantly associated with TMT‐B&W part A and part B scores. Based on these results, normative data of TMT‐B&W part A and part B for male and female were stratified for age and education level.


This study provide normative data for the new version of TMT, the TMT‐B&W which can be used in a cross‐cultural context without language translation. TMT‐B&W could be a useful neuropsychological test for illiterate or low‐educated people without the ability to understand the written letter. Age, education level and gender had significant influences on both TMT‐B&W part A and B.

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