Performance of older adults with and without neurocognitive impairment in the auditory verbal learning test: A...

This systematic review and meta-analysis aims to synthesize the performance of older adults with and without neurocognitive impairment on the Auditory Verbal Learning Test (AVLT). Specifically, the study seeks to characterize the main features of AVLT versions used in older populations, identify the most frequently assessed psychometric measures and process-based indices, and evaluate how varying levels of neurocognitive impairment affect AVLT scores.

This systematic review and meta-analysis was registered in PROSPERO and was conducted following PRISMA 2020 guidelines. A total of 44 studies were included in the review, with 42 included in the meta-analysis. Effect sizes were calculated using Hedges' g, and moderation and meta-regression analyses were performed.

The most reported version was the Rey AVLT with 15-word lists, five learning trials, and a 20-minute delay interval. Process-based indices were underreported. Individuals with neurocognitive disorders (ND) showed significantly lower AVLT scores than healthy controls, with performance worsening in line with ND severity, particularly in delayed recall. Differences in Mini-Mental State Examination scores significantly moderated total learning effect sizes, while age significantly moderated recognition hits.

The AVLT, particularly delayed recall, may be a robust tool for distinguishing among normal aging, mild and major ND. However, variability in AVLT administration reduces the diagnostic potential of AVLT. The diagnostic potential of process-based indices has not been explored adequately. Future research should prioritize the standardization of AVLT protocols and the integration of process-based indices to maximize its clinical utility in detecting and tracking neurocognitive decline.