To the best of our knowledge, the present study is the first to report on the reliability and validity of the RBANS in community-dwelling elderly in China. Many previous investigations have demonstrated the utility of the RBANS for use in the evaluation of individuals’ neuropsychological status and have considered its internal reliability and validity [7
]. The findings of our study are generally consistent with those of previous investigations. The cognitive status noted on the RBANS is broadly consistent with the results of other measures but is lower than the values reported by other studies [1
]. This finding may have resulted from the low level of education of the subjects in our study [8
]. The data demonstrate acceptable reliability. The internal reliability was robust as measured by most indices. Specifically, the internal reliability consistency of the RBANS index scores reported in this study was essentially the same as that reported by Duff, Gontkovsky et al
]. Thus, the study provided reliable and useful data, which suggested that the RBANS might be a useful and simple tool for the assessment of cognitive status in community-dwelling elderly.
The Mini-Mental State Examination, a very brief tool, is sufficient to document the severity of cognitive deficits in the elderly [17
]. The MMSE has proven to be valuable in dementia studies, where it is used as a “standard” easily communicated and cited [3
]. The MMSE also provides an interpretive context for the results in many studies. The wide use of the MMSE makes it possible to compare results across studies. The RBANS showed strong concurrent validity based upon its significant correlations with the MMSE. Most of the RBANS subtests demonstrated significant correlations with the MMSE subtests. Particularly strong were the correlations within the Immediate Memory, Delayed Memory, and Attention indices of the RBANS and most of the MMSE subtests. The RBANS subtests designed to assess memory also showed strong correlations with memory measures of the MMSE. The RBANS also showed good construct validity. Similarly, the confirmatory factor analysis conducted on the 236 community-dwelling elderly demonstrated consistently acceptable fit indices. The results of the confirmatory factor analysis indicated an acceptable fit of the Chinese version of the RBANS to the original one. Therefore, these findings demonstrate that the RBANS is commensurate with other measures known to be sensitive in community-dwelling elderly.
Previous studies have shown that the RBANS is a sensitive and clinically useful tool used to briefly screen cognitive deficits in various populations including individuals with dementia [23
], multiple sclerosis [25
], Parkinson's disease [26
], Huntington's disease [5
], stroke [29
], traumatic brain injury [22
], schizophrenia [6
], bipolar disorder [34
] and anorexia nervosa [39
]. The results of the current study add to recent research that has supported the wide use and clinical utility of the RBANS in the neuropsychological screening of various populations. In addition to the strong psychometric properties shown in present and previous studies, the short administration time, normative index scores, and alternate forms of the RBANS [22
] support its wide use in the cognitive evaluation of the elderly in the future.
Several potential limitations of this study must be highlighted. First, the current sample consisted of individuals from three communities around Tongji hospital in Shanghai, China. The generalization of these results may be limited. As a result, this research would benefit from replication in other populations with differing cognitive status and demographic characteristics. For instance, future research might explore whether the utility of the RBANS differs in different areas. Second, the current study utilized the MMSE to test the validity of the RBANS. Although the findings are promising, the relevant research would be strengthened by further comparison of the subtests with other neuropsychological measures considered to assess similar cognitive domains (e.g., comparison of the Figure Copy and its Delay trial to the Rey Complex Figure Test and its memory indices). Third, we did not collect the test-retest data, which would be a good proof of reliability. We could not prove it in this manuscript. Nevertheless, the present study contributes to the literature supporting the use of the RBANS in Chinese community-dwelling elderly samples. The Chinese translation and adaptation of the RBANS demonstrated satisfactory reliability and validity. Further studies to link more data in different samples are necessary.
In conclusion, following the results of the present study, it can be concluded that the Chinese version of the RBANS had relatively good reliability and validity in a community-dwelling elderly sample. It may be a useful screening instrument for cognitive assessment in Chinese community-dwelling elderly.