CONVERGENT VALIDITY AND AGE EFFECTS OF A VIRTUAL REALITY ADAPTATION OF THE TRAIL MAKING TEST

The Trail-Making Test (TMT) Part A and B assess processing speed and cognitive flexibility, however, their administration depends on fine motor skills. To address this limitation, we developed a virtual reality (VR) adaptation of the TMT based on eye tracking. The present study aimed to validate the VR-adapted version and to investigate its sensitivity to age-related differences in performance. We tested 87 healthy participants (mean age 45.17 ± 15.89 years, range 18-75 years) who completed both the original paper-pencil and VR-adapted versions of the TMT Part A and B. Participants completed the VR adaptation while wearing VR headsets. The setup mirrored the paper-pencil version, requiring participants to visually fixate on numbered and lettered circles in a prescribed sequence, which turned green when participants’ gaze remained on the correct target for a predefined duration, indicating successful fixation. Our analysis revealed positive correlations between total completion times of the paper- pencil and VR-adapted versions of the TMT for both Part A and Part B. Moreover, as with the original paper-pencil version, the VR-adapted version demonstrated significant age-related increases in completion times. The VR-adaptation TMT is a valid tool, , showing comparable age sensitivity and convergent validity to the paper-and-pencil version. By relying solely on eye tracking and eliminating fine motor demands, it allows the assessment of processing speed and cognitive flexibility in individuals with and without motor impairments, making it a promising tool for clinical and research settings.