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Background: The Trail Making Test (TMT) is commonly used as a neuropsychological test in clinical practice. However, the B form of original TMT (TMT-OR-B) is limited to use in other countries because it is made up with English alphabets. Therefore, in this study, two versions of Korean TMT (TMT-K: TMT-Korean Letter-B and TMT-Korean Consonant-B) and TMT-OR-B were used to examine the cognitive function for the elderly people in Korea. The purpose of this study was to find which version of three TMT was more sensitive to discriminate the group of patients with cognitive impairment in Korea and to judge whether the TMT-K was necessary. Methods: Total 115 participants (subjective memory impairment: SMI; mild cognitive impairment: MCI; early stage of Alzheimer’s disease: EAD) were tested in two vesrions of TMT-K and the TMT-OR-B. To analyze the sensitivity of these tests, we drew the receiver operating characteristics (ROC) curve and estimated area under the curve (AUC). Results: In the TMT-KL-B, it discriminated significantly between MCI and EAD (AUC=0.863) and SMI and EAD (AUC=0.917). In the TMT-OR-B, the sensitivity is relatively high in distinguishing among three groups (the AUC of SMI and MCI: 0.784; the AUC of MCI and EAD: 0.722; the AUC of SMI and EAD: 0.945). Conclusions: Consequently, the TMT-OR-B is useful for examining cognitive dysfunction of old people in Korea. However, the TMT-OR-B is more appropriate for the high-educated rather than the low-educated to differentiate normal cognitive aging from MCI or EAD.

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