Academic journal article New Zealand Journal of Psychology

Everyday Memory in an Elderly New Zealand Population: Performance on the Rivermead Behavioural Memory Test

Academic journal article New Zealand Journal of Psychology

Everyday Memory in an Elderly New Zealand Population: Performance on the Rivermead Behavioural Memory Test

Article excerpt

Assessment of memory is critical for evaluation for possible dementia. The Rivermead Behavioural Memory Test (RBMT) is one of the few measures known to have ecological validity when used with older adults. However, the norms for ages 70-94 may underestimate normal performance in well elderly people due to the sampling procedures adopted. This study reports RBMT normative data for 131 elderly, nondementing, community dwelling volunteers in New Zealand, in three age specific bands: 60-69, 70-79, 80-89 years.

Results showed significant differences between the data collected in Oxford and New Zealand. New Zealand results were higher on the summary Profile score and on six subtests with all but one of the probabilities at the p [is less than] 0.001 level. In addition, the New Zealand data favoured the use of separate norms for the 60 to 69 age group. Factors contributing to the differences are discussed. It is concluded that the New Zealand data is representative of well, independent-living older adults in contrast to the Oxford data which represents a cross-section of elderly of varying health and dependency status. This study supports the collection of normative data for specific clinical groups.

The increase in average human life expectancy from less than 50 years at the turn of the century to almost 80 years at its end, has increased the impact of age related dementias on individuals, families, caregivers and professionals. Dementia is a mind robbing, body sparing condition, responsible for large health care expense in developed countries. It results in considerable disability and emotional trauma and leads eventually to death. The increase in cases of dementia has resulted in the condition being referred to as the epidemic of the century (Plum, 1979).

The only published prevalence study of dementia in New Zealand estimated that between 1992 and 2016, prevalence will increase by 96% to 100% (National Advisory Committee on Health and Disability [NACHD] 1997) compared to the estimated rise in the population of 18% to 26%. Early diagnosis is essential for treatment planning and relies heavily upon clinical examination, neuro-imaging data and neuropsychological testing (Kaszniak, 1986; Rosenstein, 1998). Testing is essential for determining the extent of memory loss, which is a primary requirement for diagnosis (Diagnostic and Statistical Manual of Mental Disorders [4th ed.], American Psychiatric Association, 1994). Test results are also useful for providing a catalogue of cognitive strengths and weaknesses from which disease progression can be objectively measured.

Despite the obvious need for reliable memory assessment, there are surprisingly few tests suitable for assessing an elderly population (Lezak, 1995). This lack has contributed to neuropsychological assessment with elderly being recognised as one of the greatest challenges facing the neuropsychologist (Loewenstein, Arguelles, Arguelles & Linn-Feuntes, 1994). But there are also a range of special considerations important when using tests with older populations which complicate the process (see Woodruff-Pak, 1997 for a discussion of these). Furthermore, it is likely that results from conventional tests of memory overestimate the level of deficit when used with elderly populations (Kausler, 1992). Measures with high functional (face) validity would appear to improve reliability and to overcome many of the practical difficulties encountered when faced with an elderly client referred for assessment of memory function (Cunningham, 1986). The Rivermead Behavioural Memory Test (RBMT) (Cockburn & Smith, 1989; Wilson, Baddeley, Cockburn & Hiorns, 1989) is an example of a limited number of functional measures and has proven useful in clinical work with older adults in a New Zealand setting (Glass 1996). The RBMT focuses on practical memory tasks, such as recalling a short news item, remembering to do something at a certain time and putting a name to a face. …

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