台灣老年人路徑描繪測驗與彩色路徑描繪測驗心理計量特性與常模：初探研究

Psychometric Properties and Norms of the Trail Making Test and the Color Trails Test for Taiwan’s Elderly Population: A Preliminary Study

正常老化過程伴隨著認知功能的改變，尤其是執行功能與處理速度表現皆下降。路徑描繪測驗（trail making test, TMT）與彩色路徑描繪測驗（color trails test, CTT）被廣泛用於評估執行功能與處理速度。隨著全球人口快速老化，發展和更新神經心理測驗的常模資料是必要的，特別是老年人口的常模資料，以協助鑑別正常與異常認知老化。本研究目的為初步發展台灣中南部地區認知正常老年人TMT和CTT的常模資料，並評估這些測驗的心理計量特性。本研究共收集155位台灣中部及南部地區認知正常老年人常模樣本（包含65名男性和90名女性）。多元迴歸分析顯示年齡與教育程度、性別與TMT和CTT的完成時間表現有關〔校正後模型解釋力(adjusted R2) = 0.115–0.512〕，此外，CTT的提示分數以及TMT-B與TMT-A完成時間的差異（B–A）與年齡有關。間隔3個月的兩次TMT分數相關以及兩次CTT分數相關高〔組內相關係數(intraclass correlation coefficient) = 0.71–0.90〕，但具有練習效果〔最小可偵測改變比例(minimal detectable change %) = 38.2%–81.0%〕。TMT和CTT表現與語意關聯語文流利度測驗和修訂版尼爾森卡片分類測驗的表現具有顯著相關（rs = 0.375–0.752）。本研究結果顯示，TMT和CTT可能為具信效度且可應用於台灣老年人族群的神經心理衡鑑工具。

Normal aging process can be accompanied by changes in cognitive functions, especially in executive functions and processing speed. The Trail Making Test (TMT) and the Color Trails Test (CTT) are neuropsychological tests that are widely used to assess executive functions and processing speed. With the rapid aging of population globally, it is merited to develop and update normative data of neuropsychological tests, especially the normative data of elderly individuals in order to facilitate the discrimination between normal aging and pathological aging. In this study, we aimed to develop preliminary normative data of the TMT and the CTT among cognitively normal elderly individuals in central and southern Taiwan and evaluate the psychometric properties of these tests. One hundred and fifty-five cognitively normal participants (65 male and 90 female) were assessed. Multiple regression analyses revealed significant influences of age, education level, and sex on TMT and CTT performances (adjusted R2 = 0.115–0.512). In addition, number of prompts score on CTT and difference in completion time between TMT-B and TMT-A (B-A) were associated with age. Correlations between performances on two examinations separated by 3 months of the TMT and CTT were high (intraclass correlation coefficient = 0.71–0.90), whereas practice effects were observed on the second examinations (minimal detectable change % = 38.2%–81.0%). Performances on TMT and CTT significantly correlated with performance on the Semantic Association Verbal Fluency (SAVF) and the Modified Card Sorting Test (rs = 0.375 - 0.752). These results suggested that the TMT and the CTT can be reliable and valid tools for the neuropsychological assessment among elder individuals in Taiwan.