Age and educational level effects on the performance of normal elderly on category verbal fluency tasks

Abstract Cognitive decline, particularly executive dysfunction, is observed in normal aging. In Brazil, the elderly population presents broad educational diversity. Category verbal fluency tests are frequently used to detect cognitive impairment, assessing executive function, language and semantic memory. Objective: To investigate the effects of age and education on category animal fluency task (CAF) in healthy elderly. Methods: We evaluated 319 healthy elderly from outpatient care units of two university reference centers of Rio de Janeiro and São Paulo. The sample was divided into two age, and five schooling subgroups. To be included participants had to demonstrate preservation of global cognitive functioning, independence for activities of daily living and not fulfill diagnostic criteria for dementia. All participants were submitted to neurological and neuropsychological evaluations. Results: There was a correlation between age and CAF performance (r= -0.26, p<0.01), which was not confirmed when years of education were included as a covariant in univariate ANCOVA. Significant differences were found in CAF performance among the different educational level groups on correlation analysis (r=0.42, p<0.01) and ANCOVA analysis (F=18.8, p<0.05). Illiteracy was associated with worst CAF performance, while university level was associated with best performance. Conclusion: The best CAF performance was found in the first years of schooling (literacy learning process) compared to illiteracy, and when finishing high school and starting university courses compared to all other educational levels. These stages are associated with significant gains in semantic memory and executive function which are critical for verbal fluency performance.

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Normative data for healthy elderly on the phonemic verbal fluency task - FAS

Dementia & Neuropsychologia ◽

10.1590/s1980-57642009dn30100011 ◽

2009 ◽

Vol 3 (1) ◽

pp. 55-60 ◽

Cited By ~ 61

Author(s):

Thais Helena Machado ◽

Helenice Charchat Fichman ◽

Etelvina Lucas Santos ◽

Viviane Amaral Carvalho ◽

Patrícia Paes Fialho ◽

...

Keyword(s):

Test Performance ◽

Educational Level ◽

Verbal Fluency ◽

Normative Data ◽

Age Groups ◽

The Elderly ◽

Verbal Fluency Task ◽

Healthy Elderly ◽

Phonemic Verbal Fluency ◽

Student’S T

Abstract Phonemic verbal fluency tests assess the production of words beginning with specific letters. Of these letters, the most frequently used are F, A and S. It is a sensitive test for assessing frontal lobe functions. Objective: To provide normative data for the elderly Brazilian population on the FAS test and to investigate the effects of age and schooling on test performance. Methods: The individuals were divided into three age groups (60-69, 70-79 and ³80 years), and into four groups according to education (1-3, 4-7, 8-11 and ³12 years). All subjects were assessed by the Mini Mental State Examination and the FAS. Data were analyzed with Student's t test, ANOVA, simple linear regression and Spearman's correlation. Results: We evaluated 345 cognitively healthy volunteers, 66.66% being female, aged 60 to 93 years, with an educational level ranging from one to 24 years. The average (number of items) ±SD for the whole sample was 28.28±11.53. No significant effect of gender was observed (p=0.5). Performance on the MMSE and education exerted a direct influence on FAS scores (p<0.001), with education being the most significant factor. A positive correlation was found between FAS and the MMSE (r=0.404; p<0.001). Conclusion: The performance of Brazilian elderly on the phonemic verbal fluency tests-FAS is significantly influenced by education, where individuals with higher educational level present better performance than those with fewer years of schooling. Age and gender did not prove significant with the FAS.

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Elevated Anxiety Relates to Future Executive Dysfunction: A Cross-Lagged Panel Network Analysis of Psychopathology and Cognitive Functioning Components

10.31234/osf.io/hrfqa ◽

2021 ◽

Author(s):

Nur Hani Zainal ◽

Michelle G. Newman

Keyword(s):

Executive Function ◽

Network Analysis ◽

Cognitive Functioning ◽

Language Processing ◽

Verbal Fluency ◽

Executive Dysfunction ◽

Causal Inferences ◽

Cross Sectional ◽

Motor Behaviors ◽

Global Cognition

Background: Vulnerability models posit that reduced cognitive functioning abilities (e.g., verbal fluency, working memory (WM)) precede and relate to future heightened psychopathology. Conversely, scar theory postulates that elevated psychopathology coincides with subsequent reduced cognitive functioning. However, most studies so far have been cross-sectional and tested global cognitive functioning-psychopathology relations. Objective: Thus, we used cross-lagged panel network analysis (CLPN) to facilitate causal inferences and differentiation of components on this topic. Method: Community adults (n = 856) participated in this eight-year study across four waves of assessment, each spaced about two years apart. Nine psychopathology components (aberrant motor behaviors (AMB), agitation, apathy, anxiety, delusions, depression, disinhibition, hallucinations, irritability) and seven cognitive functioning (attention, episodic memory, global cognition, language, processing speed, verbal fluency, WM) multi-item nodes were assessed with various performance-based cognitive functioning tests and the caregiver-rated Neuropsychiatric Inventory. Results: Contemporaneous networks consistently showed negative associations among global cognition/verbal fluency and agitation, AMB, or hallucinations, during all waves of assessment. Nodes that were most influential across communities in contemporaneous networks were delusions, depression, WM, and verbal fluency. For temporal networks, heightened anxiety (versus other neuropsychiatric nodes), had the largest negative relations with future decreased executive and related cognitive functioning nodes. Further, executive function nodes (e.g., verbal fluency) tended to be impacted by, rather than influential on, other nodes, across all time-points. Discussion: Findings supported scar (vs. vulnerability) model. The efficacy of evidence-based cognitive-behavioral and related psychopharmacological treatments may be enhanced by adding executive function training. Other theoretical and clinical implications were discussed.

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Multiple category verbal fluency in mild cognitive impairment and correlation with CSF biomarkers for Alzheimer's disease

International Psychogeriatrics ◽

10.1017/s1041610217000102 ◽

2017 ◽

Vol 29 (6) ◽

pp. 949-958 ◽

Cited By ~ 11

Author(s):

Roberta M. Mirandez ◽

Ivan Aprahamian ◽

Leda L. Talib ◽

Orestes V. Forlenza ◽

Marcia Radanovic

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Verbal Fluency ◽

Csf Biomarkers ◽

Healthy Elderly ◽

Model Animal ◽

Neuropsychological Evaluations ◽

T Tau

ABSTRACTBackground:Verbal fluency (VF) tasks are widely used in neuropsychological evaluations, as a measure of executive/semantic dysfunction. The revised criteria for Alzheimer's disease (AD) diagnosis (National Institute on Aging and the Alzheimer Association, 2011) incorporating biomarkers has increased the interest in finding algorithms that combine neuropsychological and biomarkers features to better predict conversion from mild cognitive impairment (MCI) to AD. Our aim was to compare the most frequently used VF categories to determine which best discriminated cognitively healthy elderly from MCI patients, and whether cerebrospinal fluid (CSF) biomarkers levels (Aβ42, P-tau, T-tau, and Aβ42/P-tau) correlated with patient's performance in MCI.Methods:We studied 37 cognitively healthy elderly and 30 MCI patients in five VF tasks (animal, fruits, means of transportation, FAS-COWA, and verbs); 23 controls and 19 MCI patients had their CSF biomarkers for AD determined.Results:MCI group performed worse than controls in all VF tasks (p < 0.0001). The cut-off scores were: 14 (animals) (AUC = 0.794), 12 (fruits and means of transportation) (AUC = 0.740 and 0.719, respectively), 41 (FAS) (AUC = 0.744), and 11 (verbs) (AUC = 0.700). The model “animal plus FAS-COWA” was the best to discriminate both groups (AUC = 0.833) (all p < 0.05). MCI produced fewer words than controls in the second-half of the task for all categories (p < 0.001). T-tau levels were negatively correlated to animal fluency (r= −0.485, p = 0.035), and showed a trend for negative correlation with fruits fluency (r= −0.4429, p = 0.057).Conclusions:Animal fluency alone and combined to FAS-COWA was slightly superior in discriminating controls from MCI (p < 0.001), and correlated to T-tau levels.

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screening for cognitive impairment in late onset depression in a Brazilian sample using the BBRC-edu

Dementia & Neuropsychologia ◽

10.1590/s1980-57642012dn06020004 ◽

2012 ◽

Vol 6 (2) ◽

pp. 85-90 ◽

Cited By ~ 3

Author(s):

Tânia Maria da Silva Novaretti ◽

Marcia Radanovic ◽

Ricardo Nitrini

Keyword(s):

Cognitive Impairment ◽

Verbal Fluency ◽

Late Onset ◽

Digit Span ◽

The Elderly ◽

Control Group ◽

Brazilian Sample ◽

Depressed Patients ◽

Healthy Elderly ◽

Better Than

ABSTRACT Depression and dementia are the most prevalent neuropsychiatric disorders in the elderly population. Alzheimer's disease is the leading cause of dementia in most countries, being responsible for more than half of all dementia cases. Late-onset depression is a frequent cause of cognitive decline in the elderly. Differentiating between cognitive impairment secondary to depression and incipient dementia poses a challenge in the clinical setting. Objective: To evaluate the performance of elderly depressed patients using the BBRC-Edu. Methods: We studied 25 patients with late onset depression (mean age: 73.6 y (6.6); schooling: 9.1 y (5.7)) and 30 patients with mild AD (mean age 76.6 y (5.4); schooling: 7.5 y (7.1)), who were compared to a control group of 30 healthy elderly (mean age 73.8 y (5.8); schooling: 9.1 y (5.4)) using the CERAD and BBRC-Edu batteries. Results: For the CERAD battery, depressed patients performed better than AD patients on all tasks (p<0.0001) except for Constructional Praxis (p>0.05), and performed poorer than controls on verbal fluency (animals) and Word List Recall tasks (p<0.0001). For the BBRC-Edu, depressed patients performed better than AD patients on all tasks (p<0.0001) except for Digit Span (direct order) (p=0.076) and Incidental Memory (p>0.05), and performed worse than controls on Learning (second presentation) and verbal fluency (fruits) tasks (p<0.0001). Conclusion: Overall performance on the BBRC-Edu allowed differentiation of controls and depressed patients from AD patients.

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Communication map of elderly people: Sociodemographic and cognitive-linguistic aspects

Dementia & Neuropsychologia ◽

10.1590/s1980-57642013dn74000005 ◽

2013 ◽

Vol 7 (4) ◽

pp. 380-386

Author(s):

Marcela Lima Silagi ◽

Aline Rufo Peres ◽

Eliane Schochat ◽

Leticia Lessa Mansur

Keyword(s):

Verbal Fluency ◽

The Elderly ◽

Sociodemographic Factors ◽

Elderly Subjects ◽

Auditory Comprehension ◽

Cognitive Screening ◽

Healthy Elderly ◽

Token Test ◽

Tip Of The Tongue ◽

Healthy Elderly Subjects

ABSTRACT Language and communication difficulties may occur in the elderly population. This is the case of the tip-of-the-tongue phenomenon and receptive and auditory comprehension difficulties. Few studies have focused on examining the effects of social exposure on maintaining communication in the aging process. Objectives: [1] To describe the communication map of healthy elderly subjects; [2] To search for associations between frequency and time dedicated to communication and cognitive and sociodemographic factors. Methods: Healthy elderly subjects were submitted to cognitive screening, the Token Test - Revised, and the Verbal Fluency test, and answered the ASHA-FACS and the Circles of Communication Partners questionnaires. Results: 55 subjects, 67% female, with ages over 60 years and varied schooling were included in the sample. Interlocutors in the circle of close friends and acquaintances predominated in the communication map, although the time devoted to communication with these partners was lower than in other circles. Overall, the elderly reported no deficits in language comprehension, with some reports of the tip-of-the-tongue phenomenon. Poor performances on the Token Test - Revised and in phonemic verbal fluency along with reports of communication functionality indicated that these subjects compensate for their problems. Conclusion: Older subjects with lower schooling tended to predominantly communicate within the family circle. Within other circles, the number of hours devoted to communication and dialogue partners was not associated with age or schooling. The time devoted to the circle of communication with friends may indicate cognitive difficulties.

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Influence of age and education on the Rivermead Behavioral Memory Test (RBMT) among healthy elderly

Dementia & Neuropsychologia ◽

10.1590/s1980-57642016dn10100005 ◽

2016 ◽

Vol 10 (1) ◽

pp. 26-30 ◽

Cited By ~ 3

Author(s):

Nicole Maineri Steibel ◽

Maira Rozenfeld Olchik ◽

Mônica Sanches Yassuda ◽

Geisa Finger ◽

Irênio Gomes

Keyword(s):

Educational Level ◽

Age Groups ◽

The Elderly ◽

Cross Sectional Study ◽

Memory Test ◽

Assessment Tools ◽

Cognitive Domain ◽

Cross Sectional ◽

Healthy Elderly ◽

Behavioral Memory

Memory is a cognitive domain extensively evaluated in the neuropsychiatric setting. Assessment tools with appropriate norms for age and educational level are necessary for the proper interpretation of results. Objective : To present normative data for older adults stratified by age and education for the Rivermead Behavioral Memory Test (RBMT). The effect of age and education on the total and sub-test scores was also analyzed. Methods : A cross-sectional study involving a sample of 233 healthy elderly from a third-age group in Porto Alegre with an average age of 70 (SD 7.9) years and 10.7 (SD 4.8) years of education was carried out. The RBMT is considered an ecologically valid memory test, since it includes tasks similar to everyday situations. The sample was stratified into the following age groups: 60-69 years, 70-79 years and > 80 years. The sample was also divided into individuals with < 8 years and ≥ 8 years of education. Pearson's Chi-squared test and Spearman correlations were used. Results : The elderly participants with low educational level had worse performance on all sub-tests, except the Pictures, Messages, Belongings and Orientation. Older elderly performed worse for total RBMT score and on the Face Recognition, Immediate and Delayed Route, Messages and Belongings subtests (p ≤ 0.005). Conclusion : Education and age significantly influenced RBMT scores. Therefore, norms for this test should be stratified according to these factors.

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Verbal fluency in schizophrenia: relationship with executive function, semantic memory and clinical alogia

Psychological Medicine ◽

10.1017/s0033291700033705 ◽

1996 ◽

Vol 26 (1) ◽

pp. 39-49 ◽

Cited By ~ 115

Author(s):

E. M. Joyce ◽

S. L. Collinson ◽

P. Crichton

Keyword(s):

Executive Function ◽

Huntington's Disease ◽

Semantic Memory ◽

Verbal Fluency ◽

Normal Pattern ◽

Normal Volunteers ◽

Schizophrenic Patients ◽

Category Fluency ◽

Cognitive Abnormality ◽

Symptom Measures

SynopsisTo examine whether poor verbal fluency in schizophrenia represents a degraded semantic store or inefficient access to a normal semantic store, 25 normal volunteers and 50 DSM-III-R schizophrenic patients, matched for age, sex and IQ, were recruited. Although schizophrenic patients were impaired on both letter and category fluency, they showed a normal pattern of output in that category was superior to letter fluency, and an improvement in category fluency when a cueing technique was employed (Randolph et al. 1993). These results resemble those found in disorders of frontostriatal systems (Parkinson's and Huntington's disease) and suggest that poor verbal fluency in schizophrenia is because of inefficient access to semantic store. A measure of improvement with cueing was directly related to performance on the Stroop executive task. Of all symptom measures derived from SANS and Manchester Scales, only alogia was related to verbal fluency in that superior improvement correlated inversely with the degree of alogia. It is suggested that both alogia and poor verbal fluency are mediated by the same underlying cognitive abnormality that reflects frontostriatal dysfunction.

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Testing Cognitive Function at the Bedside

10.1093/med/9780198749189.003.0005 ◽

2017 ◽

Author(s):

John R. Hodges

Keyword(s):

Executive Function ◽

Cognitive Function ◽

Semantic Memory ◽

Cognitive Dysfunction ◽

Response Inhibition ◽

Cognitive Functions ◽

Verbal Fluency ◽

Right Hemisphere ◽

Spoken Language ◽

Set Shifting

This chapter explores the second component of assessment in patients with suspected cognitive dysfunction: testing cognitive function at the bedside. The first part of the examination should assess distributed cognitive functions, notably orientation and attention, episodic and semantic memory, and frontal executive function (initiation in the form of verbal fluency, abstraction, response inhibition, and set shifting); deficits in these indicate damage to particular brain systems, but not to focal areas of one hemisphere. The second part of the assessment deals with localized functions, divided into those associated with the dominant (i.e. the left side, in right-handers) and non-dominant hemispheres. The former relates largely to tests of spoken language with supplementary tests of reading, writing, calculation, and praxis when applicable. Testing right hemisphere function focuses on neglect (personal and extrapersonal), visuospatial and constructional abilities, and the agnosias including object and face agnosia.

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EXECUTIVE FUNCTION PERFORMANCE OF A BRAZILIAN SAMPLE OF MILD COGNITIVE IMPAIRMENT AND HEALTHY ELDERLY

10.5327/1980-5764.rpda035 ◽

2021 ◽

Author(s):

Geise Silva ◽

Isabella Avolio ◽

Camila Dias ◽

Maíra Oliveira ◽

Ricardo Nitrini ◽

...

Keyword(s):

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Verbal Fluency ◽

Healthy Aging ◽

Brazilian Sample ◽

Part C ◽

Healthy Elderly ◽

Trail Making ◽

Multiple Domains

Background: Mild cognitive impairment (MCI) is associated with cognitive alterations, usually related to memory, but can affect other domains such as executive functions (EFs), which are less explored in the literature. It is an intermediate condition between healthy aging and dementia and does not significantly affect an individual’s activities of daily living (ADL). Objectives: This study aimed to investigate executive function performance of a Brazilian sample of elderly people with multiple domains MCI (mdMCI) compared to healthy controls (HC) using EFs tasks. Methods: We included 54 subjects, 36 mdMCI and 18 HC. The EFs tasks were extracted from a comprehensive neuropsychological assessment (CAPpesq 11264) and involved the Trail Making Test (TMT), Stroop Test part C (ST), Phonemic Verbal Fluency (FAS), Semantic Verbal Fluency (SVF). Results: We observed significant differences between the groups (p <0.05) in the following task: SVF (t(25.7)= -2.582; p 0.016). Conclusions: mdMCI patients obtained a lower cognitive performance in EFs related to SVF task which is usually implicated in the cognitive fenotype of Alzheimer’s Disease continuum. These findings corroborate the international literature in mdMCI patients.

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Word-Finding Behaviors of Discourse Production Task in Healthy Elderly Adults

Audiology and Speech Research ◽

10.21848/asr.200064 ◽

2020 ◽

Vol 16 (4) ◽

pp. 347-355

Author(s):

Hyunjoo Choi

Keyword(s):

Verbal Fluency ◽

Naming Task ◽

The Elderly ◽

Word Naming ◽

Age Group ◽

Elderly Adults ◽

Discourse Production ◽

Healthy Elderly ◽

Word Finding ◽

The Difference

Purpose: The purpose of this study is to investigate whether there is a difference in word-finding behaviors in the discourse production task according to the age group of the elderly, from the young-old to the old-old.Methods: A total of 103 healthy elderly adults (55 to 85 years old) participated in this study. To exanimation of word-finding behaviors in the discourse, a picture description task was used. And, as the word naming task, the confrontational naming and the verbal fluency tasks were used.Results: First, according to the age group, the difference in the ratio of word-finding behaviors were statistically significant. Especially, there were significant differences according to the age group of the elderly in word-finding behaviors of repetitions, empty words, insertions, and delays. Second, the difference in performances of word naming task (Korean version-Boston Naming Test and semantic verbal fluency) according to the age group of the elderly was found to be significant. Finally, the performance of the word naming task showed a significant correlation with the ratio of word-finding behaviors in the discourse production task.Conclusion: This study has clinical significance in that it analyzed various word-finding behaviors in a natural environment where the problem of naming appears in elderly adults.

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