Beyond short delays: one-week recall and recognition Italian norms for the Rey–Osterrieth Complex Figure Test

The aim of this study was to establish Italian normative data for the Rey-Osterrieth Complex Figure Test (ROCFT), extending the standard protocol to include a recognition trial and a one-week delayed recall. Additionally, the study evaluated the clinical utility of these extended memory measures for detecting accelerated long-term forgetting (ALF) and for differentiating impairments in encoding, storage, and retrieval processes. A total of 413 cognitively healthy Italian adults completed the ROCFT. The protocol included a copy trial, delayed recall at 10 minutes and 1 week, and recognition trials at both delays. Recognition hits and false positives were recorded, and composite indices were computed, including Recognition Accuracy Index (RAI) and ALF indices for recall and recognition. Multiple regression analyses were conducted to adjust scores for demographic variables, and Equivalent Scores (ES) were derived using outer tolerance limits to classify performance. An automated Excel-based tool was developed to facilitate score adjustment. Normative data demonstrated significant effects of age, education, and, to a lesser extent, sex across ROCFT indices, supporting the need for demographic correction. Equivalent Score cutoffs based on outer tolerance limits provided a robust framework for classifying performance. This study provides the first Italian normative framework for the ROCFT including Recognition and one-week delayed recall and recognition trials. The extended protocol improves the test' sensitivity to subtle memory impairments and ALF, while enabling a more precise characterization of underlying cognitive mechanisms. These findings support the use of the ROCFT as a multidimensional tool for assessing visuoconstructive abilities and long-term memory processes in both clinical and research settings.