Rivermead Behavioral Memory Test - Third Edition

Brain Injury: (das Nair et al., (n.d.); n = 328 (n = 171 in intervention group and 157 in control group), age range = 18-69; TBI > 3 months prior to recruitment w/reported memory problems assessed at 6 and 12 months; intervention: 10 weekly sessions of memory rehabilitation; control group = usual care only)

• General Memory Index < 69 indicates significant memory impairment
• General Memory Index between 70 to 84 indicates borderline/moderate memory impairment
• General Memory Index > 85 indicates average and above average range

Demonstrated face validity with clients while testing (Wilson, n.d.). 

Stroke: (Man & Li, 2002; n = 86; Chinese version of RBMT (RBMT-CV))

• Excellent test-retest reliability (t = 23.4; p = 0.002)

Stroke: (Man & Li, 2002)

• Excellent: Cronbach’s alpha = 0.859

Predictive validity:

Stroke: (Man & Li, 2002)

• Adequate predictive validity of the RMBT was demonstrated through follow-up of stroke patients and correlation of their memory function with their functional status (Spearman’s rho = 0.415; p = 0.012)

Concurrent validity:

Stroke: (Man & Li, 2002)

• Excellent concurrent validity of the RBMT with the Chinese version of the Mini Mental Status Examination (MMSE) (rho = 0.86; p = 0.000)

Convergent validity: 

Healthy Elderly Population: (Steibel et al., 2016; n = 233; age > 60; mean age = 70.7 (7.9) years; female = 205) 

• Poor convergent validity between the RBMT and Educational level (r = 0.240)
• Adequate negative convergent validity between the RBMT and Age (r = -0.329)

Discriminant validity:

Healthy Elderly Population: (Steibel et al., 2016) 

• Significant ability of the RBMT to discriminate between younger (< 69 year) and older (combined 70-79 and > 80 age groups), with those < 69 having lower scores (p  < 0.001)
• Significant ability of the RBMT to discriminate between low (< 8 years) and high (> 8 years) education groups, with lower scores for the low education group (p < 0.001)

Healthy Adults: (Wester, 2014; n = 141 healthy adults, age range = 18-77 years; Dutch language version of RBMT-3) 

Means (M) and Standard Deviations (SD) of the performance on the 14 subtests for the two parallel versions of the RBMT-3

RBMT-3 Subtest

Version 1 (n = 141) M (SD)

Version 2 (n = 19)  M (SD)

First & Second Names

6.07 (2.00)

5.89 (2.02)

Belongings

6.99 (1.35)

7.47 (1.30)

Appointments

3.28 (0.887)

3.21 (0.91)

Picture Recognition

14.66 (0.705)

14.68 (0.74)

Story (IR)

7.83 (3.10)

8.95 (3.40)

Story (DR)

6.66 (3.13)

7.18 (3.25)

Face Recognition

13.31 (1.50)

13.42 (1.07)

Route (IR)

11.52 (2.15)

12.63 (1.11)

Route (DR)

11.76 (2.13)

12.26 (1.55)

Messages (IR)

5.74 (0.64)

5.89 (0.45)

Messages (DR)

5.66 (0.79)

5.89 (1.55)

Orientation & Date

12.83 (1.13)

13.32 (0.88)

Novel Task (IR)

38.63 (9.13)

45.58 (0.88)

Novel Task (DR)

14.69 (3.11)

15.95 (2.59)

IR = Immediate recall; DR = Delayed recall

Healthy Adults: (Wester, 2014) 

• Adequate: Cronbach’s alpha = 0.68 for the 14 subtests

Convergent Validity: 

Healthy Adults: (Wester, 2014) 

• Adequate convergent validity between the RBMT-3 Memory Index (MI) and Verbal IQ (R2 = 0.381, b* = 0.290, t = -3.658, p < 0.001, 95% CI: [0.005, 0.018])
• Adequate convergent validity between MI score and Age (R2 = 0.381, b* = -0.542, t = -7.124, p < 0.001, 95% CI: [-0.025, -0.014]), with 38% of the variance in MI predicted by age.

Construct validity:

Healthy Adults: (Wester, 2014) 

• Adequate construct validity of the RBMT from principal components analysis: the Kaiser-Meyer-Olkin measure of sampling adequacy was 0.682 and Bartlett’s test of sphericity was significant, X2(91) = 617.314, p  < 0.001. These figures reflect high sampling adequacy, indicating that the 14 subtests together constitute a one-dimensional scale.

Mild to Moderate Dementia, Mild Cognitive Impairment, & Healthy Controls: (Fong et al., 2019; n = 100 (29 patients w/mild to moderate dementia, 34 persons at risk for mild cognitive impairment (MCI), and 37 matched older adults as healthy control group); age ≥ 60; mean age = 70.39 (7.75) years; female = 66 (66%); Hong Kong version of RBMT-3)

• Mild Cognitive Impairment (MCI) vs. Healthy Controls (NC) cut-off scaled score: ≤ 131.5 (73% sensitivity, 50% specificity)
• MCI vs. Mild Dementia: ≤ 102.5 (100% sensitivity, 100% specificity)
• Mild vs. Moderate Dementia: ≤ 41.5 (94.1% sensitivity, 50% specificity)

Mild Cognitive Impairment, Alzheimer Disease & Healthy Controls: (Bollo-Gasol et al., 2012; n = 91; age > 60 years; mean age = 74.29 (6.71) years; female = 51 (56%); Patients examined in the dementia diagnostic unit; RBMT)

• Total RBMT Profile Score
  • Control (n  =30) vs. Alzheimer Disease (AD) (n = 34) cut-off score: 9.5 (93.3% sensitivity; 94.1% specificity)
  • Control vs. Mild Cognitive Impairment (MCI) (n = 27) cut-off score: 11.5 (67.6% sensitivity; 69.5% specificity)
• Total RBMT Screening Score
  • Control vs. AD cut-off screening score: 4.5 (93.3% sensitivity; 94.1% specificity)
  • Control vs. MCI cut-off screening score: 5.5 (69.0% sensitivity; 64.3% specificity)

Korsakoff Syndrome (KS), Cognitively Impaired Chronic Alcoholics (ALC), & Healthy Controls (CON): (Wester et al., 2013a; n = 151 (KS: n = 49, mean age = 55.6 (6.4), male = 76%; ALC: n = 49, mean age = 55.0 (6.7), male = 71%; Healthy Controls (CON): n = 53, mean age = 54.9 (7.2), male = 51%)

• KS vs ALC Global Memory Index (GMI) cut-off score: <67.5 (80% sensitivity; 69% specificity)
• ALC vs CON GMI cut-off score: 87.5 (80% sensitivity; 62% specificity)

Dementia, Stroke, Alcohol-related Disorders, Traumatic Brain Injury (TBI), & Elderly Controls: (Van Balen et al., 1996; n = 680 patients admitted within a one-year period to 35 health care services in The Netherlands and to six hospitals in the Dutch speaking part of Belgium; n = 214 healthy elderly controls; Dutch translation of RBMT)

Mean (SD) Screening and Standardized Profile Scores on the RBMT for Different RBMT Norm Groups

Norm Group

Mean Screening Score (SD)

Mean Standardized Profile Score (SD)

Dementia (n = 32)

4.5 (3.3)

11.1 (6.6)

Stroke (n = 258)

6.4 (3.4)

15.1 (6.2)

Alcohol-related Disorders (n = 77)

5.1 (3.9)

12.4 (7.6)

Traumatic Brain Injury (TBI) (n  = 164)

6.8 (3.0)

16.0 (5.5)

TBI and Coma < 7 days (n = 83)

7.4 (2.9)

17.1 (5.1)

TBI and Coma 7 - 28 days (n = 31)

7.1 (2.7)

16.8 (4.3)

TBI and Coma > 28 days (n = 37)

5.5 (2.9)

13.5 (6.0)

Elderly controls age <60 (n  = 26)

9.5 (1.8)

20.5 (2.8)

Elderly controls age 60 - 69 (n  = 99)

9.4 (2.2)

20.5 (3.6)

Elderly controls age >69 (n  = 89)

8.5 (2.4)

19.0 (4.3)

Mild to Moderate Dementia, Mild Cognitive Impairment, & Healthy Controls: (Fong et al., 2019)

• Excellent Inter-rater reliability: ICC = 0.997
• Excellent Intra-rater reliability: ICC = 0.924

Mild to Moderate Dementia, Mild Cognitive Impairment, & Healthy Controls: (Fong et al., 2019)

• Excellent: Cronbach’s alpha for Dementia group = 0.832
• Adequate: Cronbach’s alpha for Mild Cognitive Impairment group = 0.734
• Poor: Cronbach’s alpha for healthy controls = 0.643  

Predictive validity:

Mild Cognitive Impairment and Mild Dementia: (Johansson & Wressle, 2012; n = 105; Population with mild cognitive impairment (MCI) (n = 32, mean age (range) = 72 (45-91) years, male = 17), mild dementia (MD) (n = 47, mean age (range) = 75 (61-87) years, male = 25), or non-dementia (ND) (n = 26, mean age (range) = 64 (37-77) years, male = 13); RBMT)

• The RBMT has its highest positive predictive validity in the diagnosis of mild dementia at a cut-off of 5/6 (88% for positive predictive validity and 63% for negative predictive validity)

Concurrent validity:

Mild to Moderate Dementia, Mild Cognitive Impairment, & Healthy Controls: (Fong et al., 2019)

• Adequate concurrent validity of the RBMT-3 with the Montreal Cognitive Assessment (MoCA) (r = 0.359, p = 0.043) for the MCI group, but the RBMT-3 was not significantly associated with the Mini Mental State Examination (MMSE) (r = 0.322, p < .072)
• Excellent concurrent validity of the RBMT-3 for the dementia group with both the MMSE (r = 0.724, p < .001) and the MoCA (r = 0.636, p < .006)

Discriminant validity:

Korsakoff Syndrome (KS), Cognitively Impaired Chronic Alcoholics (ALC), and Healthy Controls: (Wester et al., 2013a)

• Adequate discriminant ability of the RBMT-3 to distinguish KS patients from those with chronic alcoholism.
  • AUC = 0.85; 95% CI: 0.78-0.93; p < 0.0005
• Adequate discriminant ability of the RBMT-3 to distinguish those with chronic alcoholism from healthy controls
  • AUC = 0.83: 95% CI: 0.75-0.91; p < 0.0005

Construct validity:

Mixed Populations: (Wilson, et al., 2008; n = 408 (333 normative controls (female = 172, mean age = 44.3, age range = 16-89) and 75 patients (TBI = 19, Stroke = 24, Encephalitis = 20, Progressive Conditions = 12))  

• Factor analytic results confirmed the construct validity of forming a general memory index; value not given (Wilson et al., 2008)

Alcohol-related Memory Impairment & Healthy Adults: (Wester et al., 2013b; n = 50 (25 patients with alcohol-related memory impairment (including 15 Korsakoff patients): mean age = 56.2 (7.0), male = 17 and 25 healthy adults: mean age = 42.6 (13.0), male = 16); Dutch translation of RBMT-3)

• Excellent: no floor effects for healthy adults on all RBMT-3 subtests
• Excellent: no floor effects for patients on the Pictures, Faces, Route (Immediate), Route (Delayed), Message (Delayed), Orientation, Novel Task (Immediate), and Novel Task (Delayed)
• Adequate floor effects of < 20% for patients on Belonging (4%) and Message (Immediate) (4%) subtests
• Poor floor effects of ≥ 20% for patients on the following subtests: Names (20%) and Appointment (24%)
• Poor ceiling effects of ≥ 20% for healthy adults on all RBMT-3 subscales except for Novel Task (Immediate)
• Adequate ceiling effect of < 20% for healthy adults on the Novel Task (Immediate) subscale
• Excellent: no ceiling effects for patients for the Faces, Route (Immediate), Route (Delayed), and Novel Task (Immediate) subscales
• Adequate ceiling effects of < 20% for patients on the Names (8%), Orientation (4%), and Novel Task (Delayed) (8%) subtests
• Poor ceiling effects of ≥ 20% for patients on the following subtests: Belonging (32%), Appointment (24%), Pictures (32%), Message (Immediate) (32%), Message (Delayed) (20%)

Korsakoff Syndrome (KS), Cognitively Impaired Chronic Alcoholics (ALC), and Healthy Controls (HC): (Wester et al., 2013a)

• Large Change between Korsakoff patients and healthy controls for all RBMT-3 subtests (d = -0.92 to -4.03)
• Moderate Change between Cognitively Impaired Alcoholics and Healthy Controls on RBMT-3 subtests: Story Recall (Immediate) (d = -0.51), Story Recall (Delayed) (d = -0.45), Messages (Immediate) (d = -0.44), and Orientation and Date (d = -0.59)
• Large Change between Cognitively Impaired Alcoholics and Healthy Controls on RBMT-3 subtests: Names (d = -0.89), Belonging (d = -0.82), Appointment (d = -0.99), Picture Recognition (Delayed) (d = -0.93), Face Recognition (Delayed) (d = -1.64), Route Recall (Immediate) (d = -0.90), Route Recall (Delayed) (d = -1.20), Messages (Delayed) (d = -0.81), Novel Task (Immediate) (d = -0.93), Novel Task (Delayed) (d = -0.81), and Global Memory Index (d = -1.39)