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Rehab Measures Database

Rivermead Behavioral Memory Test - Third Edition

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Purpose

The Rivermead Behavioral Memory Test Third Edition, also known as RBMT-3, assesses everyday memory function and problems with 14 subtests. It can be used as an initial assessment and to measure changes over time after rehabilitation interventions. It can be helpful to use in neuropsychological settings and may be performed by a variety of professionals. 

Link to Instrument

Acronym RBMT-3

Area of Assessment

Cognition
Attention & Working Memory
Vision & Perception
Communication

Assessment Type

Performance Measure

Administration Mode

Paper & Pencil

Cost

Not Free

Actual Cost

$638.90

Cost Description

Cost figure is for complete starter kit including Manual, 25 Record Forms, 2 Stimulus Books, Novel Task Stimulus Material, Storycard, Message Envelope, Alarm, and Timer. Support materials include:
--RBMT-3 Record Forms (25) - $123.20
--RBMT-3 Administration & Scoring Manual - $138.90
--RBMT-3 Stimulus Book 1 - $141.30
--RBMT-3 Stimulus Book 2 - $141.40
--RBMT-3 Storycard (print) - $19.50
--RBMT-3 Message Envelope – 10.50
--RBMT-3 Novel Task Stimulus Material - $92.10
--RBMT-3 Alarm - $15.80

CDE Status

Not a CDE—last searched: 03/12/2024

Key Descriptions

  • 14 subtests
  • 2 versions to allow retesting; Version 1 must be used before Version 2
  • During the administration of the assessment, the practitioner should follow the instructions in the assessment manual. In the manual, there are scripts for the practitioner to read, along with pictures and additional instructions for the practitioner to use. The assessment should be conducted in a quiet environment where the client can attend fully to all the tasks.
  • Minimum score for every subtest: 0; Maximum score: 24
  • The subtest scores are determined by counting how many items the participant gets correct.
  • The subtest scores are then standardized (so the scores can have equal weight) and summed to produce the “Profile score”.
  • This Profile score is transformed into a percentile score according to age.
  • After testing, a “General Memory Index,” and sub-scores in various listed areas are assigned to the client based on their subtest scores.
  • The General Memory Index is the standardized score that the test provides and follows the principles of standardized assessment. Like an IQ score with an average being 100 and a standard deviation of 15, any score between 85 –115 is classed as an average score as these scores fall within one standard deviation of the mean.

Number of Items

14 subtests:
1. First & Second Names - Delayed Recall
2. Belongings - Delayed Recall
3. Appointments - Delayed Recall
4. Picture Recognition - Delayed Recognition
5. Story - Immediate Recall
6. Story - Delayed Recall
7. Face Recognition - Delayed Recognition
8. Route - Immediate Recall
9. Route - Delayed Recall
10. Messages - Immediate Recall
11. Messages - Delayed Recall
12. Orientation & Date
13. Novel Task - Immediate Recall
14. Novel Task - Delayed Recall

Equipment Required

  • Manual
  • 25 Record Forms
  • 2 Stimulus Books
  • Novel Task Stimulus Material
  • Storycard
  • Message Envelope
  • Alarm
  • Timer

Time to Administer

25-30 minutes

Required Training

Training Course

Required Training Description

May be purchased by individuals with:
1) A master's degree in psychology, education, speech language pathology, occupational therapy, social work, counseling, or in a field closely related to the intended use of the assessment, and formal training in the ethical administration, scoring, and interpretation of clinical assessments -- OR
2) Certification by of full active membership in a professional organization (such as ASHA, AOTA, AERA, ACA, AMA, CEC, AEA, AAA, EAA, NAEYC, NBCC, CVRP) that requires training and experience in the relevant area of assessment -- OR
3) A degree of license to practice in the healthcare or allied healthcare field -- OR
4) Formal, supervised mental health, speech/language, occupational therapy, social work, counseling, and/or educational training specific to assessing children, or in infant and child development, and formal training in the ethical administration, scoring, and interpretation of clinical assessments -- OR
5) Work for an accredited institution

Age Ranges

Adolescent

16 - 17

years

Adult

16 - 64

years

Elderly Adult

65 - 96

years

Instrument Reviewers

Reviewed June, 2024 by University of Illinois Entry-Level Occupational Therapy Doctorate students Jazmin Villanueva, Ashley Tafur, Lilyanna Patton, and Abigail Smith under the direction of Sabrin Rizk, PhD, OTR/L, Department of Occupational Therapy, University of Illinois Chicago.

ICF Domain

Body Function
Participation

Measurement Domain

Cognition
Activities of Daily Living

Professional Association Recommendation

Not found—last searched: 03/12/2024

Considerations

  • Helpful for use with those with more severe cognitive deficits, such as in acute settings and with older adults
  • New subtest “Novel Task” which tests new learning
  • Includes case studies, recommendations for interventions, and suggestions for interpretation
  • Uses real-life tests, such as recalling story details and recalling names and faces

Brain Injury

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Cut-Off Scores

Brain Injury: (das Nair et al., (n.d.); = 328 (= 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

Face Validity

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

Stroke

back to Populations

Test/Retest Reliability

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

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

Internal Consistency

Stroke: (Man & Li, 2002)

  • Excellent: Cronbach’s alpha = 0.859

Criterion Validity (Predictive/Concurrent)

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)

 

Older Adults and Geriatric Care

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Construct Validity

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 (= -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 (< 0.001)

 

Healthy Adults

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Normative Data

Healthy Adults: (Wester, 2014; = 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 (= 141) M (SD)

Version 2 (= 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

 

Internal Consistency

Healthy Adults: (Wester, 2014) 

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

Construct Validity

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, < 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, < 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.

 

Mixed Populations

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Cut-Off Scores

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) (= 34) cut-off score: 9.5 (93.3% sensitivity; 94.1% specificity)
    • Control vs. Mild Cognitive Impairment (MCI) (= 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: = 49, mean age = 55.6 (6.4), male = 76%; ALC: = 49, mean age = 55.0 (6.7), male = 71%; Healthy Controls (CON): = 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)

 

Normative Data

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; = 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 (= 32)

4.5 (3.3)

11.1 (6.6)

Stroke (= 258)

6.4 (3.4)

15.1 (6.2)

Alcohol-related Disorders (= 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 (= 83)

7.4 (2.9)

17.1 (5.1)

TBI and Coma 7 - 28 days (= 31)

7.1 (2.7)

16.8 (4.3)

TBI and Coma > 28 days (= 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)

 

Interrater/Intrarater Reliability

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
 

Internal Consistency

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  

Criterion Validity (Predictive/Concurrent)

Predictive validity:

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

 

Construct Validity

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; = 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)

 

Floor/Ceiling Effects

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%)

 

Responsiveness

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

 

Bibliography

Bolló-Gasol, S., Pi?ol-Ripoll, G., Cejudo-Bolivar, J. C., Llorente-Vizcaino, A., & Peraita-Adrados, H. (2014). Ecological assessment of mild cognitive impairment and Alzheimer disease using the Rivermead Behavioural Memory Test. Neurología (English Edition), 29(6), 339-345. 

das Nair, R., Bradshaw, L. E., Carpenter, H., Clarke, S., Day, F., Drummond, A., ... & Lincoln, N. B. (n.d.) The Clinical and Cost-Effectiveness of Rehabilitation of Memory in Brain Injury: The ReMemBrIn RCT.

Fong, K. N. K., Lee, K. K. L., Tsang, Z. P. Y., Wan, J. Y. H., Zhang, Y. Y., & Lau, A. F. C. (2019). The clinical utility, reliability and validity of the Rivermead Behavioural Memory Test-Third Edition (RBMT-3) in Hong Kong older adults with or without cognitive impairments. Neuropsychological Rehabilitation29(1), 144–159. 

Johansson, M., & Wressle, E. (2012). Validation of the neurobehavioral cognitive status examination and the Rivermead Behavioural Memory Test in investigations of dementia. Scandinavian Journal of Occupational Therapy, 19(3), 282-287. 

Man, D. W. K., & Li, R. (2002). Assessing Chinese adults' memory abilities: Validation of the Chinese version of the Rivermead Behavioral Memory Test. Clinical Gerontologist, 24(3-4), 27-36. 

Steibel, N. M., Olchik, M. R., Yassuda, M. S., Finger, G., & Gomes, I. (2016). Influence of age and education on the Rivermead Behavioral Memory Test (RBMT) among healthy elderly. Dementia & Neuropsychologia, 10(1), 26-30. 

Van Balen, H. G. G., Westzaan, P. S. H., Mulder, T. (1996). Stratified Norms for the Rivermead Behavioural Memory Test. Neuropsychological Rehabilitation, 6(3), 203–218. 

Wester, A. J. (2014, Dissertation). Assessment of everyday memory in patients with alcohol-related cognitive disorders using the Rivermead Behavioral Memory Test. 

Wester, A. J., van Herten, J. C., Egger, J. I., & Kessels, R. P. (2013a). Applicability of the Rivermead Behavioural Memory Test – Third Edition (RBMT-3) in Korsakoff’s syndrome and chronic alcoholics. Neuropsychiatric Disease and Treatment, 9, 875–881. 

Wester, A. J., Leenders, P., Egger, J. I. M., & Kessels, R. P. C. (2013b). Ceiling and floor effects on the Rivermead Behavioural Memory Test in patients with alcohol-related memory disorders and health participants. International Journal of Psychiatry in Clinical Practice, 17, 286-291. 

Wilson, B. A., Greenfield, E., Clare, L., Baddeley, A., Cockburn, J., Watson, P., Tate, R., Sopena, S., Nannery R., & Crawford J., (2008). RBMT3. [PowerPoint Slides]. Pearson Clinical Assessment.