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Validation of the Trail Making Test B for the Cognitive Assessment of Patients with Cancer in Palliative Care

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DOI: 10.4236/ojs.2014.46042    3,092 Downloads   3,905 Views   Citations

ABSTRACT

Introduction: Cognitive impairment is common in patients with cancer; however, studies examining the adaptation and validation of instruments for use in patients with cancer are scarce. Purpose: The purpose of this study was to validate the Trail Making Test B (TMT-B) for use in patients with cancer. Methods: Ninety-four outpatients receiving palliative treatment and 39 healthy companions were assessed. Patients were tested with the TMT-B and answered questions regarding the presence and intensity of pain, fatigue, quality of sleep, anxiety, and depression, at two time points with a 7-day inter-assessment interval. Results: The instrument discriminated between patients, who were slower, and healthy companions with respect to the time required to complete the test, but not in terms of the number of errors. The test was stable for the healthy companions across the two assessments in terms of time to complete the TMT-B and the number of errors; for patients, the instrument was stable only for the number of errors. Performance on the TMT-B did not correlate with pain, fatigue, depression, anxiety, or sensation of rest. Conclusions: TMT-B cannot be considered fully validated. Further studies incorporating and comparing other instruments evaluating executive function and mental flexibility are needed.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Santos, J. , Pimenta, C. , Kurita, G. , Braga, P. and Sjøgren, P. (2014) Validation of the Trail Making Test B for the Cognitive Assessment of Patients with Cancer in Palliative Care. Open Journal of Statistics, 4, 435-445. doi: 10.4236/ojs.2014.46042.

References

[1] Bruera, E., Miller, L., McCallion, J., Macmillan, K., Krefting, L. and Hanson, J. (1992) Cognitive Failure in Patients with Terminal Cancer: A Prospective Study. Journal of Pain and Symptom Management, 7, 192-195.
http://dx.doi.org/10.1016/0885-3924(92)90074-R
[2] Brant, J.M. (2010) Palliative Care for Adults across the Cancer Trajectory: From Diagnosis to End of Life. Seminars in Oncology Nursing, 26, 222-230.
http://dx.doi.org/10.1016/j.soncn.2010.08.002
[3] Centeno, C., Sanz, A. and Bruera, E. (2004) Delirium in Advanced Cancer Patients. Palliative Medicine, 18, 184-194.
http://dx.doi.org/10.1191/0269216304pm879oa
[4] Irwin, S.A., Zurhellen, C.H., Diamond, L.C., Dunn, L.B., Palmer, B.W., Jeste, D.V. and Twamley, E.W. (2008) Unrecognised Cognitive Impairment in Hospice Patients: A Pilot Study. Palliative medicine, 22, 842-847.
http://dx.doi.org/10.1177/0269216308096907
[5] Leonard, M., Agar, M., Mason, C. and Lawlor, P. (2008) Delirium Issues in Palliative Care Settings. Journal of Psychosomatic Research, 65, 289-298.
http://dx.doi.org/10.1016/j.jpsychores.2008.05.018
[6] Kurita, G.P., Sjøgren, P., Ekholm, O., Kaasa, S., Loge, J.H., Poviloniene, I. and Klepstad, P. (2011) Prevalence and Predictors of Cognitive Dysfunction in Opioid-Treated Patients with Cancer: A Multinational Study. Journal of Clinical Oncology, 29, 1297-303.
http://dx.doi.org/10.1200/JCO.2010.32.6884
[7] Mehta, M.P., Shapiro, W.R., Glantz, M.J., Patchell, R.A., Weitzner, M.A., Meyers, C.A. and Renschler, M.F. (2002) Lead-In Phase to Randomized Trial of Motexafin gadolinium and Whole-Brain Radiation for Patients with Brain Metastases: Centralized Assessment of Magnetic Resonance Imaging, Neurocognitive, and Neurologic end Points. Journal of clinical oncology, 20, 3445-3453.
http://dx.doi.org/10.1200/JCO.2002.07.500
[8] Meyers, C.A., Smith, J.A., Bezjak, A., Mehta, M.P., Liebmann, J., Illidge, T. and Renschler, M.F. (2004) Neuro- cognitive Function and Progression in Patients with Brain Metastases Treated with Whole-Brain Radiation and Motexafin Gadolinium: Results of a Randomized Phase III Trial. Journal of Clinical Oncology, 22, 157-165.
http://dx.doi.org/10.1200/JCO.2004.05.128
[9] Spreen, O. and Strauss, E. (1998) A Compendium of Neuropsychological Tests: Administration, Norms and Commentary. 2nd Edition, Oxford University Press, New York.
[10] Kurita, G.P., Santos, J. and Pimenta, C.A.M. (2011) Cognitive Assessment of Cancer Patient in Palliative Care: A Systematic Review. Abstracts Book 12th Congress of the European Association for Palliative Care, EAPC, Lisbon, 19-21 May 2011, 159-159.
[11] Arbuthnott, K. and Frank, J. (2000) Trail Making Test, Part B as a Measure of Executive Control: Validation Using a Set-Switching Paradigm. Journal of clinical and experimental neuropsychology, 22, 518-528.
http://dx.doi.org/10.1076/1380-3395(200008)22:4;1-0;FT518
[12] Cangoz, B., Karakoc, E. and Selekler, K. (2009) Trail Making Test: Normative Data for Turkish Elderly Population by Age, Sex and Education. Journal of the Neurological Sciences, 283, 73-78.
http://dx.doi.org/10.1016/j.jns.2009.02.313
[13] Giovagnoli, A.R, Del Pesce, M., Mascheroni, S., Simoncelli, M., Laiacona, M. and Capitani, E. (1996) Trail Making Test: Normative Values from 287 Normal Adult Controls. Italian journal of neurological sciences, 17, 305-309.
http://dx.doi.org/10.1007/BF01997792
[14] Lezak, M., Howieson, D.B. and Loring, D.W. (2004) Neuropsychological Assessment. 4th Edition, Oxford University Press, New York.
[15] Kurita, G.P. and Pimenta, C.A.M. (2008)Cognitive Impairment in Cancer Pain Patients Receiving Opioids: A Pilot Study. Cancer Nursing, 31, 49-57.
http://dx.doi.org/10.1097/01.NCC.0000305673.06211.cd
[16] Li, J., Bentzen, S.M., Li, J.L., Renschler, M. and Mehta, M.P. (2008) Relationship between Neurocognitive Function and Quality of Life after Whole-Brain Radiotherapy in Patients with Brain Metastasis. International Journal of Radiation Oncology, Biology, Physics, 71, 64-70.
http://dx.doi.org/10.1016/j.ijrobp.2007.09.059
[17] Karnofsky, D.A. and Burchenal, J.H. (1949) The Clinical Evaluation of Chemotherapeutic Agents in Cancer. In: MacLeod, C.M., Ed., Evaluation of Chemotherapeutic Agents, Columbia University Press, New York, 196-196.
[18] Williamson, A. and Hoggart, B. (2005) Pain: A Review of Three Commonly Used Pain Rating Scales. Journal of Clinical Nursing, 14, 798-804.
http://dx.doi.org/10.1111/j.1365-2702.2005.01121.x
[19] Mota, D.D.C.F., Pimenta, C.A.M. and Fitch, M.I. (2009) Fatigue Pictogram: An Option for Assessing Fatigue Severity and Impact. Revista da Escola de Enfermagem da USP, 43, 1080-1087.
[20] Ble, A., Volpato, S., Zuliani, G., Guralnik, J.M., Bandinelli, S., Lauretani, F., Bartali, B., Maraldi, C., Fellin, R. and Ferrucci, L. (2005) Executive Function Correlates with Walking Speed in Older Persons: The InCHIANTI Study. Journal of the American Geriatrics Society, 53, 410-415.
http://dx.doi.org/10.1111/j.1532-5415.2005.53157.x
[21] Reitan Neuropsychological Laboratory (2012)
http://www.mcssl.com/store/reitan-neuropsychology-laboratory/tests/trail-making-test-for-
adults-item-18
[22] Botega, N.J., Bio, M.R., Zomignani, M.A., Garcia Jr., C. and Pereira, W.A.B. (1995) Transtornos do humor em enfermaria de clínica médica e validação de escala de medida (HAD) de ansiedade e depressão. Revista de Saúde Pública, 29, 355-363.
http://dx.doi.org/10.1590/S0034-89101995000500004
[23] Bjelland, I., Dahl, A.A., Haug, T.T. and Neckelmann, D. (2002) The Validity of The Hospital Anxiety and Depression Scale: An Updated Literature Review. Journal of Psychosomatic Research, 52, 69-77.
http://dx.doi.org/10.1016/S0022-3999(01)00296-3
[24] Brucki, S.M., Nitrini, R., Caramelli, P., Bertolucci, P.H. and Okamoto, I.H. (2003) Suggestions for Utilization of the Mini-Mental State Examination in Brazil. Sugestões para o uso do mini-exame do estado mental no Brasil. Arquivos de Neuro-Psiquiatria, 61, 777-781.
http://dx.doi.org/10.1590/S0004-282X2003000500014
[25] Tombaugh, T.N. (2004) Trail Making Test A and B: Normative Data Stratified by Age and Education. Archives of Clinical Neuropsychology, 19, 203-214.
http://dx.doi.org/10.1016/S0887-6177(03)00039-8
[26] Hirota, C., Watanabe, M., Sun, W., Tanimoto, Y., Kono, R., Takasaki, K. and Kono, K. (2010) Association between the Trail Making Test and Physical Performance in Elderly Japanese. Geriatrics & Gerontology International, 10, 40-47. http://dx.doi.org/10.1111/j.1447-0594.2009.00557.x
[27] Kuo, T.T. and Ma, F.C. (2002) Symptom Distresses and Coping Strategies in Patients with Non-Small Cell Lung Cancer. Cancer Nursing, 25, 309-317.
http://dx.doi.org/10.1097/00002820-200208000-00007
[28] Davidson, J.R., MacLean, A.W., Brundage, M.D. and Schulze, K. (2002) Sleep Disturbance in Cancer Patients. Social Science & Medicine, 54, 1309-1321.
http://dx.doi.org/10.1016/S0277-9536(01)00043-0
[29] Spoletini, I., Caltagirone, C., Ceci, M., Gianni, W. and Spalletta, G. (2010) Management of Pain in Cancer Patients with Depression and Cognitive Deterioration. Surgical Oncology, 19, 160-166.
http://dx.doi.org/10.1016/j.suronc.2009.11.006
[30] Moriarty, O., McGuire, B.E. and Finn, D.P. (2011) The Effect of Pain on Cognitive Function: A Review of Clinical and Preclinical Research. Progress in Neurobiology, 93, 385-404.
http://dx.doi.org/10.1016/j.pneurobio.2011.01.002
[31] Ruffolo, L.F., Guilmette, T.J. and Willis, G.W. (2000) FORUM Comparison of Time and Error Rates on the Trail Making Test among Patients with Head Injuries, Experimental Malingerers, Patients with Suspect Effort on Testing, and Normal Controls. The Clinical Neuropsychologist, 14, 223-230.
http://dx.doi.org/10.1076/1385-4046(200005)14:2;1-Z;FT223
[32] Mahurin, R.K., Velligan, D.I., Hazleton, B., Mark Davis, J., Eckert, S. and Miller, A.L. (2006) Trail Making Test Errors and Executive Function in Schizophrenia and Depression. The Clinical Neuropsychologist, 20, 271-288.
http://dx.doi.org/10.1080/13854040590947498
[33] Ashendorf, L., Jefferson, A.L. and O’Connor, M.K. (2008) Trail Making Test Errors in Normal Aging, Mild Cognitive Impairment, and Dementia. Archives of Clinical Neuropsychology, 23, 129-137.

  
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