Generalizability of reliable change equations for the RBANS over one year in community-dwelling older adults

Objective: Reliable change methods can assist neuropsychologists in determining whether observed changes in a patient's performance are clinically meaningful. The current study sought to validate previously published standardized regression-based (SRB) equations for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Indexes and subtests. Methods: Duff and colleagues's SRB prediction equations, developed from 223 cognitively intact primary care patients, were applied to an independent sample of robustly cognitively intact (n = 129) community-dwelling older adults assessed with the RBANS twice over a one-year period. Results: Results suggest that the cognitively intact participants in the current validation sample possessed significantly better Observed Follow-up scores than was predicted based on Duff's developmental sample across most RBANS Indexes and many RBANS subtests, though significantly lower Observed Follow-up scores were observed for the Visuospatial/Constructional Index than was predicted. As a result of these findings, the current study calculated updated prediction algorithms for the RBANS Index and subtest scores from the sample of 129 cognitively intact participants. Conclusions: Duff's 2004 and 2005 SRB prediction equations for the RBANS Index and subtest scores failed to generalize to a sample of cognitively intact community-dwelling participants recruited from senior living centers and independent assisted living facilities. These updated SRB prediction equations - being developed from a more medically "clean" sample of cognitively intact older adults who remained stable over 12 months - have the potential to provide a more accurate assessment of reliable change in an individual patient.