Spanish Normative Data for TMA-93 (Binding by Images): Descriptive Analysis - European Medical Journal

Spanish Normative Data for TMA-93 (Binding by Images): Descriptive Analysis

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*Emilio Franco-Macías, Silvia Rodrigo-Herrero, Pablo Baena, Eugenia Graciani-Cantisán, María Bernal Sánchez-Arjona, Andrea Luque-Tirado, Ana Baquero- Ramírez, María Dolores Jiménez-Hernández

This study has received financial support by Hoffmann-La Roche. The authors report not additional conflicts of interest.

EMJ Neurol. . ;7[1]:42-43. AR3.

Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.


TMA-93 is a French memory test that examines binding by images.1 Drawings of familiar objects of everyday life are displayed in semantically related pairs during the encoding phase; participants must recall the missing drawing when the associated one is provided. This retrieval phase is repeated up to three times to assess participants’ learning abilities.1 The maximum total score is 30 out of 30.1 The aim of this study was to report the preliminary results of an ongoing normative study from Spanish population for the test.


Partners of patients who attended the Memory Unit, Hospital Virgen del Rocío, Seville, Spain, from July 2018 to April 2019 were invited to participate. These patients were aged ≥50 years old; had no memory complaints; scored ≥10th percentile on Phototest, a short cognitive test with normative data in Spain; and gave informed consent. Age (<65, ≥65), educational attainment (<first grade, first grade, or >first grade), and gender were considered as sociodemographic variables. A stratified analysis by combinations of significant socio-demographic variables was performed.


In total, 1,091 subjects were included from July 2018 to April 2019. Total scores for TMA-93 showed a non-normal, left asymmetric, and leptokurtic distribution (P5=22, P10=24, P25=27, P50=29, P75=30). There were significant differences between groups according to age and educational attainment, so a stratified analysis by these sociodemographic variables was undertaken (Table 1).


Total scores for TMA-93 show a non-normal, left asymmetric and leptokurtic distribution in Spanish people aged ≥50 years old. The test works with a ceiling effect that is mitigated by older age and lower educational attainment.

Table 1: Normative data stratified by age and education for TMA-93 total scores.

Maillet D et al. The TMA-93: A new memory test for Alzheimer’s disease in illiterate and less educated people. Am J Alzheimers Dis Other Demen. 2017;32(8):461-7.

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