Modified Wisconsin Card Sorting Test: standardization and norms of the test for a population sample in Spain

Introduction. The Modified Wisconsin Card Sorting Test (M-WCST) is a shorter, modified version of the WCST that assesses executive functioning and mental flexibility. The M-WCST presents some differences and advantages compared to other versions of the WCST, as previously described in the scientific literature. Aim. To standardize and develop demographically-calibrated norms for the M-WCST in a sample representing of the population of Spain. Subjects and methods. This study is part of the multisite Normacog project. Seven hundred participants from 18 to 90 years old were assessed using the M-WCST. The effects of age, sex, and educational level on M-WCST performance were analyzed, and demographically-calibrated percentiles and scaled scores corresponding to each raw score were created. Results. The effect of age and level of education on the M-WCST variables analyzed (correct categories, perseverative errors and total errors) was statistically significant, whereas sex was not significant. Age and education explained 5.0-21.2% of the variance in M-WCST performance. Older participants with lower level of formal education completed fewer category sorts and made more errors than younger and more educated participants. Conclusion. This study reports the first normative data for the M-WCST in a contemporary Spanish sample, taking socio-demographic characteristics of the population into account. The influence of age and level of education on the M-WCST performance was confirmed.