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Updated: Jun 12, 2026

The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease
Published on: October 13, 2016
[Detection of memory impairment among community-dwelling elderly by using the Rivermead Behavioural Memory Test]
Shunichiro Shinagawa1, Yasutaka Toyota, Teruhisa Matsumoto
1Department of Psychiatry, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
Aim:
The aim of this study was to use the Rivermead Behavioural Memory Test (RBMT) to evaluate everyday memory impairment among community-dwelling elderly who had normal cognitive function and performed daily activities normally but displayed memory impairments,and to diagnose the condition as either mild cognitive impairment or dementia.
Method:
Among the 1,290 community-dwelling elderly persons who participated in the study, 72 subjects scored higher than 24 on the Mini-Mental State Examination (MMSE): these subjects performed daily activities normally, but their family members reported that they showed memory impairments. Fifty-two subjects completed RBMT, Clinical Dementia Rating, and brain computed tomography, and a final diagnosis was established.
Results:
The mean standard profile score was 15.1+/-5.0 and mean screening score was 6.4+/-3.0. RBMT score was correlated with the MMSE score. Nine of the subjects were diagnosed with dementia and 26 of them were found to be normal. RBMT achieved 100% sensitivity and specificity with regard to the differentiation of subjects with Alzheimer's disease. However, some subjects were diagnosed with dementia even though their RBMT score was higher than the cut-off score.
Conclusion:
RBMT was useful in detecting memory impairments of AD subjects in community-based surveys. However, some subjects were diagnosed with dementia because of the existence of other cognitive impairments among community-dwelling elderly.
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