DOI: 10.1002/alz.071058 ISSN: 1552-5260

Are serial position effect patterns in the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) invariant across genders?

Julie A Suhr, Cardinal A. Do, Adrienne A. Jankowski
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Geriatrics and Gerontology
  • Neurology (clinical)
  • Developmental Neuroscience
  • Health Policy
  • Epidemiology



Although more men are diagnosed with Mild Cognitive Impairment, more women are diagnosed with Alzheimer’s disease. Disparities in diagnosis may reflect a female advantage in verbal memory across the lifespan such that, when norms are collapsed across gender, women with subtle cognitive decline are not detected until further in the course of illness. Patterns of verbal memory performance, such as the serial position effect (SPE) may be invariant to gender and thus may minimize these diagnostic discrepancies. However, few studies have examined whether SPE patterns and their relationships to outcome are invariant to gender.


338 adults 50 years of age or older participated in community dementia screening, which included the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Average age was 66.9 years, 94% were white, and 67% identified as women. None had major neuromedical or neurodegernative diagnosis. RBANS List Learning was used to identify primacy, middle, and recency recall on Trial 1 and at delayed recall. We also calculated recency ratio (percent of recency words recalled at delay/percent recency words at Trial 1).


We identified expected SPE patterns for Trial 1 and at delayed recall; the patterns were invariant to gender. Primacy at Trial 1, middle of the list at Trial 1, and recency ratio all predicted RBANS Delayed Memory Index; there was no interaction with gender. Using cluster analysis, we divided the sample into those with better primacy than recency and those with better recency than primacy at Trial 1. Those with better primacy than recency on Trial 1 did better on the Delayed Memory Index; this was not moderated by gender. SPE findings were specific to delayed memory.


Results show that the SPE patterns identified on longer word list learning tasks can also be identified on a cognitive screening battery. Further, although traditional memory scores showed gender disparities, SPE patterns and relationships were invariant to gender.

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