PsychologyMedicine

Yasuhisa Nakamura, Reiko Miyamoto, Akihiro Koreki, Sachiko Anamizu, M. Mimura

2026.5.8Applied Neuropsychology-Adult

DOI: 10.1080/23279095.2026.2668605

Abstract

The Modified Tinkertoy Test (m-TTT) is a performance-based, self-structured construction task that may complement structured neuropsychological measures by capturing self-initiated goal setting, planning, execution, monitoring, and self-correction in open-ended performance. Demographically informed reference data for Japanese adults remain limited. This study developed preliminary community-based reference data and regression-based standard scores for the m-TTT in Japanese adults aged 20-59 years. Adults were stratified by age decade and sex. Of 132 individuals assessed, 8 were excluded because of elevated psychological distress or failure to meet the right-handedness criterion, leaving 124 participants (62 men, 62 women; 31 per decade). Age decade-by-sex differences were examined using analysis of covariance with years of education as a covariate, and regression-based z scores and standard scores were derived using age, sex, and education. After adjustment for education, years of education were associated with score, whereas age decade, sex, and their interaction were not significant. The mean m-TTT score was 10.91 (SD = 2.40), and the education-adjusted model explained 3.4% of score variance (R2 = .034; adjusted R2 = .010; RMSE = 2.39). These findings provide a reference framework for adults aged 20-59 years. The resulting scores should be interpreted as reference indices rather than definitive norms.

Citation format

NAKAMURA, Yasuhisa, et al. Community-based reference data and regression-based standard scores for interpreting modified tinkertoy test performance in japanese adults. Applied Neuropsychology-Adult, 2026: 1–7.