Culturally Sensitive Normative Data for the Color Trails Test in the Indian Population

Abstract

Objective The Color Trails Test (CTT) is a neuropsychological measure tapping into frontal and executive functioning, while at the same time minimizing the cultural and language barriers inherent in similar neurocognitive measures such as the Trail Making Test (TMT). This study generates culturally-appropriate normative data for the CTT in an adult Indian population. Method Six-hundred and sixty-nine cognitively healthy, community dwelling Indian individuals between ages 18 and 69 participated in the study. Eligible participants were stratified on the basis of age, gender, and educational attainment. Participant performance on the CTT and TMT were correlated to establish concurrent validity. Results Significant correlations were found between TMT-part A and CTT-part 1 (r = .61) and between TMT-part B and CTT-part 2 (r = .66). In addition to generating culturally-appropriate normative data, the current study found that age and educational attainment significantly impacted participant performance on CTT-Part 1 [F(4, 649) = 4.395, p = .002], whereas gender, along with age, and educational attainment significantly impacted performance on CTT-Part 2 [F(4,649) = 2.446, p = .045]. In general, younger participants with more educational attainment performed better on both parts of the CTT. Interestingly, older female participants with lower educational attainment performed better than their younger counterparts on CTT-Part 2, whereas no such findings were noted for male participants. Conclusions Age, gender, and educational attainment are important factors to consider when interpreting CTT completion times in the Indian population. Normative data generated from this study has important clinical implications and contributes to the growing body of culturally-appropriate normative data available for the Indian population.