Ten German versions of Rey’s auditory verbal learning test: Age and sex effects in 4,000 adults of the Rhineland Study

Abstract

INTRODUCTION: Detecting early pathological cognitive decline is critical for dementia and aging-related research and clinical diagnostics. Rey's Auditory Verbal Learning Test (AVLT) is commonly used to measure episodic verbal memory. The test requires participants to learn a list of 15 words over several trials. Since multiple testing is often required to detect cognitive decline, but repeating the same test can bias results, we developed 10 German AVLT word lists. METHOD: We randomly assigned the lists to 4,000 participants (aged 30-94 years) from a population-based cohort to test their comparability, as well as aging effects and sex differences. RESULTS: Nine lists were highly comparable, with only one being slightly more difficult. Recall performance decreased on average by 0.6-1.1 words per trial per decade of age. Perseveration errors decreased with increasing age. Women remembered on average between 0.8 and 1.5 words per trial more than men, regardless of age. Women also outperformed men in the sum of Trials 1-5, learning over trials, retroactive inhibition, and false-positive and interference errors. Proactive inhibition remained stable across age and was unaffected by sex. CONCLUSION: This German AVLT version presents comparable lists including detailed age and sex references and therefore allows test repetition excluding training effects. These versions are a valuable resource for research and clinical application.