OLDER ADULTS LEARNING, MEMORY, AND COPY PERFORMANCE ON THE REY-OSTERRIETH AND MODIFIED TAYLOR COMPLEX FIGURES

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1 The University of British Columbia OLDER ADULTS LEARNING, MEMORY, AND COPY PERFORMANCE ON THE REY-OSTERRIETH AND MODIFIED TAYLOR COMPLEX FIGURES Anita M. Hubley University of British Columbia Vancouver, BC, Canada Presented at the Annual Meeting of the National Academy of Neuropsychology, Vancouver, BC, Canada, October 13-16, 2010 Funding: This study has been supported by research funds from the University of British Columbia. Correspondence: Dr. Anita M. Hubley, Dept. of ECPS, 2125 Main Mall, University of British Columbia, Vancouver, BC, Canada, V6T 1Z4; ABSTRACT The Rey-Osterrieth (ROCF) and Modified Taylor (MTCF) complex figures generally produce comparable accuracy scores on learning, memory, and copy in adults, although Hubley (2010) raises questions about the comparability of copy scores in older adults. Hubley also found no gender differences in accuracy scores on either figure, small and nonsignificant correlations between figure performance and age on both figures, small and positive correlations between figure performance and education that were generally nonsignificant on both figures, and no statistically significant differences between the ROCF and the MTCF among each set of correlations. The purposes of this study were to examine, in older adults, whether the two figures show comparable (a) accuracy scores on learning, memory, and copy, and (b) correlations between accuracy scores and demographic variables (gender, age, and education) using a between-groups design and an intentional learning procedure. INTRODUCTION The Rey-Osterrieth Complex Figure (ROCF; Rey, 1941 see left side of Figure 1) is one of the most commonly used measures of visuospatial abilities in neuropsychological practice. Most commonly, the clinician or researcher wants to evaluate visuospatial functioning more than once, although some may simply wish to use an alternate figure to which a patient or subject has not been exposed. To minimize practice effects associated with using the same complex figure twice, it is recommended practice to use a different, but equally difficult, complex figure. The Modified Taylor Page 1 of 6

2 Complex Figure (MTCF; Hubley, 1998; Hubley & Tremblay, 2002 see right side of Figure 1) was developed to serve as a comparable alternate figure to the ROCF. Several studies (Hubley & Jassal, 2006; Hubley & Tremblay, 2002; Yamashita, 2006) have reported comparable accuracy score performance on the ROCF and the MTCF when a between-groups design with either an incidental or intentional learning paradigm or a within-subjects design with an intentional learning paradigm have been used. Hubley and Tombaugh (2003) noted that surprisingly little research comparing alternate forms of complex figures has been conducted with older adults. To date, it appears that only one study comparing the ROCF and MTCF has focused solely on this age group. Using a between-groups design with an incidental learning procedure in a group of community-dwelling older adults ages years, Hubley (2010) found comparable accuracy score performance on immediate and delayed recall, but significantly better performance (by 1.6 out of 36 points) on the MTCF than ROCF at copy. She also reported no gender differences in accuracy scores on either figure, small nonsignificant correlations between accuracy scores and age on both figures, small positive and (with one exception) nonsignificant correlations between figure performance and education on both figures, and similar patterns of correlations with both figures. The aims of the present study were to examine, in older adults, whether the ROCF and MTCF showed (a) comparable accuracy scores on learning, memory, and copy, and (b) similar correlations between accuracy scores and demographic variables (i.e., gender, age, and education) using a between-groups design and an intentional learning procedure. Participants METHOD The sample consisted of 86 adults (18 men, 68 women), ages (M = 66.3; SD = 5.99) with 8-21 (M = 14.9, SD = 2.70) years of education, recruited from the general community. Individuals who scored lower than 24 on the Mini-Mental State Examination (MMSE) or higher than 12 on the Geriatric Depression Scale (GDS) were excluded from the study. Procedure A between-groups design was used wherein participants received either the ROCF (n = 43) or the MTCF (n = 43). An intentional learning procedure, with four learning trials followed by 20-minute delayed recall and then copy, was employed. Figures were scored using the standard 36-point accuracy scoring systems (see Lezak et al., 2004). Page 2 of 6

3 RESULTS Table 1 shows accuracy score performance on the four learning trials, total acquisition, delayed recall trial, and copy trial for the ROCF and MTCF. Statistical analyses (i.e., independent samples t-tests, Mann-Whitney U nonparametric tests, and two-way Figure x Trials mixed model ANOVA, as appropriate) indicated that there were no significant score differences between the figures on any of the trials. Table 2 shows the correlations between accuracy scores and the demographic variables on learning, memory, and copy trials for each figure. Correlations between accuracy scores and (a) gender were low (r pb = -.17 to.10), (b) age were low to moderate (r = -.43 to.16) and (c) education were low to moderate (r =.27 to.50). Importantly, the results of the Fisher Z-test showed that there were no significant differences between the figures in these correlations. CONCLUSION The results of this study indicate that learning, memory, and copy accuracy scores on the ROCF and MTCF are comparable in older adults when an intentional learning procedure is used. These results are consistent with previous research indicating that the ROCF and the MTCF produce comparable accuracy scores in samples of younger adults (Hubley & Tremblay, 2002; Yamashita, 2006) and in a mixed age adult sample (Hubley & Jassal, 2006) using incidental and intentional learning procedures. These results are also generally consistent with Hubley s (2010) study with older adults but, unlike that study, the current study found no significant score differences between the figures on the copy trial. Accuracy scores on both figures showed low nonsignificant point-biserial correlations with gender. This finding is consistent with the majority of research on gender differences in complex figures (see Hubley & Tombaugh, 2003; Hubley, 2010). Correlations between accuracy scores on both figures and age tended to be negative and small to moderate in magnitude. This finding is consistent with Hubley (2010), with the relatively lower correlations than seen in other research likely reflecting the restricted age range present in samples of older adults. Correlations between accuracy scores on both figures and education were positive and small to moderate in magnitude. These findings are consistent with those of Hubley s (2010) study of older adults and larger in magnitude than other studies (e.g., Hubley & Jassal, 2006), suggesting the importance of education in this age group. More importantly, none of the correlations between complex figure performance and each of the demographic variables was statistically significantly different between the ROCF and the MTCF in the present study. Only four studies appear to have conducted comparability studies by examining the respective patterns of correlations between performance on different complex figures and demographic variables (Frazier et al., 2001; Hubley, 2010; Hubley & Jassal, 2006; Vingerhoets et al., 1998). In the only previous studies comparing the ROCF and the MTCF, Hubley (2010) and Hubley and Page 3 of 6

4 Jassal (2006) also found similar patterns of correlations between the ROCF and the MTCF. REFERENCES Frazier, T. W., Adams, N. L., Strauss, M. E., & Redline, S. (2001). Comparability of the Rey and Mack forms of the Complex Figure Test. The Clinical Neuropsychologist, 15, Hubley, A.M. (1998). Scoring system for the Modified Taylor Complex Figure (MTCF). Unpublished research. University of Northern British Columbia, Prince George, BC. Hubley, A. M. (2010). Using the Rey-Osterrieth and Modified Taylor Complex Figures with older adults: A preliminary examination of accuracy score comparability. Archives of Clinical Neuropsychology, 25, Hubley, A. M., & Jassal, S. (2006). Comparability of the Rey-Osterrieth and Modified Taylor Complex Figures using total scores, completion times, and construct validation. Journal of the International Neuropsychological Society, 28, Hubley, A. M., & Tombaugh, T. N. (2003). Comparability of the Rey-Osterrieth and Taylor Complex Figures. In J. A. Knight and E. F. Kaplan (Eds.), The handbook of Rey-Osterrieth Complex Figure usage:clinical and research applications (pp ). Lutz, FL: Psychological Assessment Resources. Hubley, A.M., & Tremblay, D. (2002). Comparability of total score performance on the Rey- Osterrieth Complex Figure and a Modified Taylor Complex Figure. Journal of Clinical and Experimental Neuropsychology, 24, Lezak, M. D., Howieson, D. B., and Loring, D. W. (2004). Neuropsychological assessment (4 th ed.). New York: Oxford University Press. Rey, A. (1941). L examen psychologie dan les cas d encephalopathie traumatique (Les problemes) Archives de Psychologie, 28, Vingerhoets, G., Lannoo, E., & Wolters, M. (1998). Comparing the Rey Osterrieth and Taylor Complex Figures: Empirical data and meta-analysis. Psychologica Belgica, 38, Yamashita, H. (2006). Comparability of the Rey Osterrieth Complex Figure, the Taylor Complex Figure, and the Modified Taylor Complex Figure in a normal sample of Japanese speakers. Psychological Reports, 99, Disclosure of Potential Conflict of Interest: Dr. Hubley is the developer of the Modified Taylor Complex Figure (MTCF). She holds the copyright on this figure, although she has made the figure freely available for use in research and clinical practice. Page 4 of 6

5 Figure 1: Left: Rey-Osterrieth Complex Figure; Right: Modified Taylor Complex Figure Table 1 Accuracy Score Performance (M, SD) on the Rey-Osterrieth and Modified Taylor Complex Figures Trials Figure n Trial 1 Trial 2 Trial 3 Trial 4 Tot. Acq. 20-min. Delayed Recall Copy ROCF M SD (4.70) 20.6 (5.72) 24.0 (5.42) 26.0 (5.63) 84.6 (19.50) 25.3 (5.40) 31.2 (3.67) MTCF M SD (4.66) 19.7 (5.52) 23.4 (5.63) 25.8 (5.45) 82.0 (21.20) 25.1 (5.26) 31.3 (3.01) Note. ROCF = Rey-Osterrieth Complex Figure; MTCF = Modified Taylor Complex Figure; Tot. Acq. = Total Acquisition (summed across Trials 1-4; out of 144). Page 5 of 6

6 Table 2 Correlations between Demographic Variables and Performance on the Rey-Osterrieth and Modified Taylor Complex Figures Demographic Variables ROCF MTCF Fisher s Z-test Trial 1 Gender Z = 0.58, n.s. Age b Z = 1.38, n.s. Education Z = 0.10, n.s. Total Acquisition Gender Z = 0.32, n.s. Age a Z = 0.93, n.s. Education.50 b.28 Z = 1.17, n.s. Delayed Recall Trial Gender Z = 0.50, n.s. Age Z = 0.09, n.s. Education.42 b.31 a Z = 0.57, n.s. Copy Trial Gender Z = 0.13, n.s. Age Z = 0.95, n.s. Education.33 a.45 b Z = 0.63, n.s. Note: a p <.05; b p <.01; n = 43 per figure; ROCF = Rey-Osterrieth Complex Figure; MTCF = Modified Taylor Complex Figure; Tot. Acq. = Total Acquisition (summed across Trials 1-4); Gender: 1 = male, 2 = female; Education = in years Pearson correlations are reported for age and education whereas point-biserial correlations are reported for gender. Page 6 of 6