The Rey Auditory Verbal Learning Test: Cross-validation of Mayo Normative Studies (MNS) demographically corrected norms with confidence interval estimates

• Published in: Journal of the International Neuropsychological Society Vol. 29; no. 4; pp. 397 - 405
• Main Authors: Loring, David W., Saurman, Jessica L., John, Samantha E., Bowden, Stephen C., Lah, James J., Goldstein, Felicia C.
• Format: Journal Article
• Language: English
• Published: New York, USA Cambridge University Press 01.05.2023
• Subjects: Age; Aged; Alzheimer's disease; Auditory discrimination learning; Confidence Intervals; Datasets; Demography; Education; Female; Hearing; Humans; Male; Males; Memory; Memory and Learning Tests; Mental Recall; Middle Aged; Neuropsychological Tests; Recognition, Psychology; Reference Values; Standardization; Statistical analysis; Verbal Learning; United States > US; Minnesota; leaning and memory; demographic correction; confidence intervals; predicted true score; reliability and validity
• ISSN: 1355-6177; 1469-7661; 1469-7661
• DOI: 10.1017/S1355617722000248

The Mayo Normative Studies (MNS) represents a robust dataset that provides demographically corrected norms for the Rey Auditory Verbal Learning Test. We report MNS application to an independent cohort to evaluate whether MNS norms accurately adjust for age, sex, and education differences in subjects from a different geographic region of the country. As secondary goals, we examined item-level patterns, recognition benefit compared to delayed free recall, and derived Auditory Verbal Learning Test (AVLT) confidence intervals (CIs) to facilitate clinical performance characterization. Participants from the Emory Healthy Brain Study (463 women, 200 men) who were administered the AVLT were analyzed to demonstrate expected demographic group differences. AVLT scores were transformed using MNS normative correction to characterize the success of MNS demographic adjustment. Expected demographic effects were observed across all primary raw AVLT scores. Depending on sample size, MNS normative adjustment either eliminated or minimized all observed statistically significant AVLT differences. Estimated CIs yielded broad CI ranges exceeding the standard deviation of each measure. The recognition performance benefit across age ranged from 2.7 words ( = 2.3) in the 50-54-year-old group to 4.7 words ( = 2.7) in the 70-75-year-old group. These findings demonstrate generalizability of MNS normative correction to an independent sample from a different geographic region, with demographic adjusted performance differences close to overall performance levels near the expected value of = 50. A large recognition performance benefit is commonly observed in the normal aging process and by itself does not necessarily suggest a pathological retrieval deficit.