Verbal fluency in Alzheimer’s disease and mild cognitive impairment in individuals with low educational level and its relationship with reading and writing habits
Verbal fluency (VF) has contributed to building cognitive maps as well as differentiating healthy populations from those with dementia. Objectives: To compare the performance of healthy controls and patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in two semantic VF tasks (...
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| Published in | Dementia & neuropsychologia Vol. 14; no. 3; pp. 300 - 307 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
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Brazil
Associação de Neurologia Cognitiva e do Comportamento
01.09.2020
Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento Associação Neurologia Cognitiva e do Comportamento |
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| Abstract | Verbal fluency (VF) has contributed to building cognitive maps as well as differentiating healthy populations from those with dementia. Objectives: To compare the performance of healthy controls and patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in two semantic VF tasks (animals/clothes) and a phonemic VF task (letter P). Also, to analyze the relationship between the frequency of reading and writing habits (FRWH) and VF in individuals with low educational level. Methods: Sixty-seven older adults aged 60-80 years and with 2-8 years of schooling were divided into three groups: controls (n=25), older adults with MCI (n=24), and older adults with AD (n=18). We analyzed the type, mean size, and number of clusters, switches, intersections, and returns. A post-hoc single-factor ANOVA analysis was conducted to verify differences between groups. Results: Total words in the phonemic VF and the animal category discriminated the three groups. Regarding the animal category, AD patients performed worse than controls in the total number of words, taxonomic clusters, returns, and number of words remembered. We found a moderate correlation between FRWH and total number of words in the phonemic fluency. Conclusions: Semantic (animate) and phonemic (total words) VF differentiated controls and clinical groups from each other - the phonemic component was more related to FRWH than the semantic one. The phonemic VF seems to be more related to cognitive reserve. VF tasks, considering total words and cluster analyses, are a valuable tool to test healthy and cognitively impaired older adults who have a low educational level.
RESUMO. A tarefa de fluência verbal (FV) contribui para um mapeamento cognitivo e diferenciação entre populações saudáveis e com demência. Objetivos: Comparar o desempenho em duas tarefas de FV semântica (animais/roupas) e uma fonêmica (letra P) entre controles saudáveis e pacientes com Comprometimento Cognitivo Leve (CCL) e Doença de Alzheimer (DA). Além disso, analisar a relação entre frequência de hábitos de leitura e escrita (FHLE) e a FV nesses grupos de baixa escolaridade. Métodos: Sessenta e sete adultos idosos foram divididos em três grupos: controles (n=25), idosos com CCL (n=24) e idosos com DA (n=18), 60-80 anos de idade e 2-8 anos de escolaridade. Avaliaram-se tipo, tamanho médio e quantidade de agrupamentos, alternâncias, intersecções e retornos. Conduziu-se uma análise ANOVA de um fator com post hoc para verificar diferenças entre grupos. Resultados: O total de palavras na FV fonêmica e a categoria animais discriminaram os três grupos. Na categoria animais, pacientes com DA demonstraram desempenho inferior ao dos controles no número total de palavras, agrupamentos taxonômicos, retornos e número de palavras evocadas. Houve correlação moderada entre FHLE e número total de palavras na FV fonêmica. Conclusões: O componente semântico (animado) e o fonêmico (total de palavras) da FV diferenciaram os controles e os grupos clínicos entre si; o fonêmico relacionou-se mais com a FHLE do que o semântico. A FV fonêmica parece ser mais relacionada à reserva cognitiva. Tarefas de FV, considerando o total de palavras e as análises de clusters, são ferramentas valiosas para testar adultos idosos saudáveis e com declínio cognitivo na baixa escolaridade. |
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| AbstractList | Verbal fluency (VF) has contributed to building cognitive maps as well as differentiating healthy populations from those with dementia.
To compare the performance of healthy controls and patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) in two semantic VF tasks (animals/clothes) and a phonemic VF task (letter P). Also, to analyze the relationship between the frequency of reading and writing habits (FRWH) and VF in individuals with low educational level.
Sixty-seven older adults aged 60-80 years and with 2-8 years of schooling were divided into three groups: controls (n=25), older adults with MCI (n=24), and older adults with AD (n=18). We analyzed the type, mean size, and number of clusters, switches, intersections, and returns. A post-hoc single-factor ANOVA analysis was conducted to verify differences between groups.
Total words in the phonemic VF and the animal category discriminated the three groups. Regarding the animal category, AD patients performed worse than controls in the total number of words, taxonomic clusters, returns, and number of words remembered. We found a moderate correlation between FRWH and total number of words in the phonemic fluency.
Semantic (animate) and phonemic (total words) VF differentiated controls and clinical groups from each other - the phonemic component was more related to FRWH than the semantic one. The phonemic VF seems to be more related to cognitive reserve. VF tasks, considering total words and cluster analyses, are a valuable tool to test healthy and cognitively impaired older adults who have a low educational level. Verbal fluency (VF) has contributed to building cognitive maps as well as differentiating healthy populations from those with dementia. Objectives: To compare the performance of healthy controls and patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in two semantic VF tasks (animals/clothes) and a phonemic VF task (letter P). Also, to analyze the relationship between the frequency of reading and writing habits (FRWH) and VF in individuals with low educational level. Methods: Sixty-seven older adults aged 60-80 years and with 2-8 years of schooling were divided into three groups: controls (n=25), older adults with MCI (n=24), and older adults with AD (n=18). We analyzed the type, mean size, and number of clusters, switches, intersections, and returns. A post-hoc single-factor ANOVA analysis was conducted to verify differences between groups. Results: Total words in the phonemic VF and the animal category discriminated the three groups. Regarding the animal category, AD patients performed worse than controls in the total number of words, taxonomic clusters, returns, and number of words remembered. We found a moderate correlation between FRWH and total number of words in the phonemic fluency. Conclusions: Semantic (animate) and phonemic (total words) VF differentiated controls and clinical groups from each other - the phonemic component was more related to FRWH than the semantic one. The phonemic VF seems to be more related to cognitive reserve. VF tasks, considering total words and cluster analyses, are a valuable tool to test healthy and cognitively impaired older adults who have a low educational level. RESUMO. A tarefa de fluência verbal (FV) contribui para um mapeamento cognitivo e diferenciação entre populações saudáveis e com demência. Objetivos: Comparar o desempenho em duas tarefas de FV semântica (animais/roupas) e uma fonêmica (letra P) entre controles saudáveis e pacientes com Comprometimento Cognitivo Leve (CCL) e Doença de Alzheimer (DA). Além disso, analisar a relação entre frequência de hábitos de leitura e escrita (FHLE) e a FV nesses grupos de baixa escolaridade. Métodos: Sessenta e sete adultos idosos foram divididos em três grupos: controles (n=25), idosos com CCL (n=24) e idosos com DA (n=18), 60-80 anos de idade e 2-8 anos de escolaridade. Avaliaram-se tipo, tamanho médio e quantidade de agrupamentos, alternâncias, intersecções e retornos. Conduziu-se uma análise ANOVA de um fator com post hoc para verificar diferenças entre grupos. Resultados: O total de palavras na FV fonêmica e a categoria animais discriminaram os três grupos. Na categoria animais, pacientes com DA demonstraram desempenho inferior ao dos controles no número total de palavras, agrupamentos taxonômicos, retornos e número de palavras evocadas. Houve correlação moderada entre FHLE e número total de palavras na FV fonêmica. Conclusões: O componente semântico (animado) e o fonêmico (total de palavras) da FV diferenciaram os controles e os grupos clínicos entre si; o fonêmico relacionou-se mais com a FHLE do que o semântico. A FV fonêmica parece ser mais relacionada à reserva cognitiva. Tarefas de FV, considerando o total de palavras e as análises de clusters, são ferramentas valiosas para testar adultos idosos saudáveis e com declínio cognitivo na baixa escolaridade. Verbal fluency (VF) has contributed to building cognitive maps as well as differentiating healthy populations from those with dementia. Verbal fluency (VF) has contributed to building cognitive maps as well as differentiating healthy populations from those with dementia.Verbal fluency (VF) has contributed to building cognitive maps as well as differentiating healthy populations from those with dementia.To compare the performance of healthy controls and patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) in two semantic VF tasks (animals/clothes) and a phonemic VF task (letter P). Also, to analyze the relationship between the frequency of reading and writing habits (FRWH) and VF in individuals with low educational level.OBJECTIVESTo compare the performance of healthy controls and patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) in two semantic VF tasks (animals/clothes) and a phonemic VF task (letter P). Also, to analyze the relationship between the frequency of reading and writing habits (FRWH) and VF in individuals with low educational level.Sixty-seven older adults aged 60-80 years and with 2-8 years of schooling were divided into three groups: controls (n=25), older adults with MCI (n=24), and older adults with AD (n=18). We analyzed the type, mean size, and number of clusters, switches, intersections, and returns. A post-hoc single-factor ANOVA analysis was conducted to verify differences between groups.METHODSSixty-seven older adults aged 60-80 years and with 2-8 years of schooling were divided into three groups: controls (n=25), older adults with MCI (n=24), and older adults with AD (n=18). We analyzed the type, mean size, and number of clusters, switches, intersections, and returns. A post-hoc single-factor ANOVA analysis was conducted to verify differences between groups.Total words in the phonemic VF and the animal category discriminated the three groups. Regarding the animal category, AD patients performed worse than controls in the total number of words, taxonomic clusters, returns, and number of words remembered. We found a moderate correlation between FRWH and total number of words in the phonemic fluency.RESULTSTotal words in the phonemic VF and the animal category discriminated the three groups. Regarding the animal category, AD patients performed worse than controls in the total number of words, taxonomic clusters, returns, and number of words remembered. We found a moderate correlation between FRWH and total number of words in the phonemic fluency.Semantic (animate) and phonemic (total words) VF differentiated controls and clinical groups from each other - the phonemic component was more related to FRWH than the semantic one. The phonemic VF seems to be more related to cognitive reserve. VF tasks, considering total words and cluster analyses, are a valuable tool to test healthy and cognitively impaired older adults who have a low educational level.CONCLUSIONSSemantic (animate) and phonemic (total words) VF differentiated controls and clinical groups from each other - the phonemic component was more related to FRWH than the semantic one. The phonemic VF seems to be more related to cognitive reserve. VF tasks, considering total words and cluster analyses, are a valuable tool to test healthy and cognitively impaired older adults who have a low educational level. Verbal fluency (VF) has contributed to building cognitive maps as well as differentiating healthy populations from those with dementia. Objectives: To compare the performance of healthy controls and patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in two semantic VF tasks (animals/clothes) and a phonemic VF task (letter P). Also, to analyze the relationship between the frequency of reading and writing habits (FRWH) and VF in individuals with low educational level. Methods: Sixty-seven older adults aged 60-80 years and with 2-8 years of schooling were divided into three groups: controls (n=25), older adults with MCI (n=24), and older adults with AD (n=18). We analyzed the type, mean size, and number of clusters, switches, intersections, and returns. A post-hoc single-factor ANOVA analysis was conducted to verify differences between groups. Results: Total words in the phonemic VF and the animal category discriminated the three groups. Regarding the animal category, AD patients performed worse than controls in the total number of words, taxonomic clusters, returns, and number of words remembered. We found a moderate correlation between FRWH and total number of words in the phonemic fluency. Conclusions: Semantic (animate) and phonemic (total words) VF differentiated controls and clinical groups from each other - the phonemic component was more related to FRWH than the semantic one. The phonemic VF seems to be more related to cognitive reserve. VF tasks, considering total words and cluster analyses, are a valuable tool to test healthy and cognitively impaired older adults who have a low educational level. |
| Author | Tessaro, Bruna Kochhann, Renata Schilling, Lucas Porcello Hermes-Pereira, Andressa Hübner, Lilian Cristine Fonseca, Rochele Paz |
| AuthorAffiliation | 2 Psychology Department, Universidade Federal do Rio Grande do Sul - Porto Alegre, RS, Brazil 1 Linguistics Department, Pontifícia Universidade Católica do Rio Grande do Sul - Porto Alegre, RS, Brazil 3 Brain Institute - Porto Alegre, RS, Brazil 4 Neurology Service, São Lucas Hospital, Pontifícia Universidade Católica do Rio Grande do Sul - Porto Alegre, RS, Brazil 5 Psychology Department, Pontifícia Universidade Católica do Rio Grande do Sul - Porto Alegre, RS, Brazil 6 National Council for Scientific and Technological Development - Brasília, DF, Brazil |
| AuthorAffiliation_xml | – name: 2 Psychology Department, Universidade Federal do Rio Grande do Sul - Porto Alegre, RS, Brazil – name: 5 Psychology Department, Pontifícia Universidade Católica do Rio Grande do Sul - Porto Alegre, RS, Brazil – name: 3 Brain Institute - Porto Alegre, RS, Brazil – name: 4 Neurology Service, São Lucas Hospital, Pontifícia Universidade Católica do Rio Grande do Sul - Porto Alegre, RS, Brazil – name: 6 National Council for Scientific and Technological Development - Brasília, DF, Brazil – name: 1 Linguistics Department, Pontifícia Universidade Católica do Rio Grande do Sul - Porto Alegre, RS, Brazil – name: Universidade Federal do Rio Grande do Sul – name: Pontifícia Universidade Católica do Rio Grande do Sul – name: National Council for Scientific and Technological Development – name: Brain Institute |
| Author_xml | – sequence: 1 givenname: Bruna orcidid: 0000-0002-1420-3269 surname: Tessaro fullname: Tessaro, Bruna organization: Pontifícia Universidade Católica do Rio Grande do Sul, Brazil – sequence: 2 givenname: Andressa orcidid: 0000-0002-2110-2095 surname: Hermes-Pereira fullname: Hermes-Pereira, Andressa organization: Universidade Federal do Rio Grande do Sul, Brazil – sequence: 3 givenname: Lucas Porcello orcidid: 0000-0002-9923-6982 surname: Schilling fullname: Schilling, Lucas Porcello organization: Brain Institute, Brazil; Pontifícia Universidade Católica do Rio Grande do Sul, Brazil – sequence: 4 givenname: Rochele Paz orcidid: 0000-0001-6767-8439 surname: Fonseca fullname: Fonseca, Rochele Paz organization: Pontifícia Universidade Católica do Rio Grande do Sul, Brazil; National Council for Scientific and Technological Development, Brazil – sequence: 5 givenname: Renata orcidid: 0000-0002-6328-8131 surname: Kochhann fullname: Kochhann, Renata organization: Pontifícia Universidade Católica do Rio Grande do Sul, Brazil – sequence: 6 givenname: Lilian Cristine orcidid: 0000-0002-7876-2211 surname: Hübner fullname: Hübner, Lilian Cristine organization: Pontifícia Universidade Católica do Rio Grande do Sul, Brazil; National Council for Scientific and Technological Development, Brazil |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32973983$$D View this record in MEDLINE/PubMed |
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| Keywords | habits Alzheimer’s Disease writing fluency reading Mild Cognitive Impairment schooling escrita hábitos Doença de Alzheimer leitura escolaridade fluência Comprometimento Cognitivo Leve |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Disclosure: The authors report no conflicts of interest. Authors’ contributions. BT: conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, project administration, visualization, writing - original draft, writing - review & editing. AHP: data curation, formal analysis, investigation, methodology, resources, software, writing - original draft, writing - review & editing. LPS: conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, project administration, resources, supervision. RPF: conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, project administration, supervision, validation, visualization, writing - original draft, writing - review & editing. RK: conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, project administration, software, supervision, validation, visualization, writing - original draft, writing - review & editing. LH: conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, project administration, resources, software, supervision, validation, visualization, writing - original draft, writing - review & editing. |
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| Publisher | Associação de Neurologia Cognitiva e do Comportamento Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento Associação Neurologia Cognitiva e do Comportamento |
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article-title: Normative data for clustering and switching on verbal fluency tasks publication-title: J Clin Exp Neuropsychol – volume: 4 start-page: 137 issue: 2 year: 1998 end-page: 143 article-title: Clustering and switching on verbal fluency tests in Alzheimer’s and Parkinson’s disease publication-title: J Int Neuropsychol Soc – volume: 155 start-page: 24 issue: 156 year: 2016 end-page: 35 article-title: Neuroanatomical correlates of verbal fluency in early Alzheimer’s disease and normal aging publication-title: Brain Lang – volume: 4 start-page: 35 issue: 1 year: 2010 end-page: 41 article-title: The Mini Mental State Examination: Review of cutoff points adjusted for schooling in a large Southern Brazilian sample publication-title: Dement Neuropsychol – volume: 25 start-page: 2275 issue: 9 year: 2012 end-page: 2289 article-title: The influence of reading and writing habits associated with education on the neuropsychological performance of Brazilian adults publication-title: Read Writ – volume: 44 start-page: 1928 issue: 10 year: 2006 end-page: 1935 article-title: The nature of lexico-semantic processing deficits in mild cognitive impairment publication-title: Neuropsychologia – volume: 5 start-page: 244 issue: 6 year: 2001 end-page: 252 article-title: Towards a distributed account of conceptual knowledge publication-title: Trends Cogn Sci – volume: 12 start-page: 231 issue: 2 year: 1996 end-page: 240 article-title: Does education influence the age‐related cognitive decline? A further inquiry publication-title: Dev Neuropsychol – volume: 7 start-page: 270 issue: 3 year: 2011 end-page: 279 article-title: The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease publication-title: Alzheimers Dement – volume: 1 start-page: 72 issue: 1 year: 2009 end-page: 80 article-title: Evidências do papel da escolaridade na organização cerebral publication-title: Neuropsicol Lat Am – volume: 26 start-page: 680 issue: 4 year: 2013 end-page: 690 article-title: Efeito da idade, escolaridade, hábitos de leitura e escrita, processamento semântico e sintomas de depressão na fluência verbal publication-title: Psicol Reflex Crit – volume: 42 start-page: 1212 issue: 9 year: 2004 end-page: 1222 article-title: Verbal fluency performance in dementia of the Alzheimer’s type: A meta-analysis publication-title: Neuropsychologia – volume: 14 start-page: 167 issue: 2 year: 1999 end-page: 177 article-title: Normative data stratified by age and education for two measures of verbal fluency: FAS and animal naming publication-title: Arch Clin Neuropsychol – volume: 2 start-page: 164 issue: 3 year: 2008 end-page: 164 article-title: Literacy as a determining factor for brain organization: from Lecours’ contribution to the present day publication-title: Dement Neuropsychol – volume: 30 start-page: 303 issue: 4 year: 2008 end-page: 310 article-title: Validity and applicability of the Mini International Neuropsychiatric Interview administered by family medicine residents in primary health care in Brazil publication-title: Gen Hosp Psychiatry – volume: 13 start-page: 203 issue: 2 year: 2019 end-page: 209 article-title: Discriminative validity of an abbreviated Semantic Verbal Fluency Test publication-title: Dement Neuropsychol – volume: 1 start-page: 212 issue: 2 year: 2007 end-page: 216 article-title: Brazilian adaptation of the Addenbrooke’s Cognitive Examination Revised (ACE-R) publication-title: Dement Neuropsychol – volume: 129 start-page: 3066 year: 2006 end-page: 3080 article-title: Semantic dementia and fluent primary progressive aphasia: two sides of the same coin? publication-title: Brain – volume: 21 start-page: 1081 issue: 6 year: 2009 end-page: 1087 article-title: Verbal fluency in the detection of mild cognitive impairment and Alzheimer’s disease among Brazilian Portuguese speakers: the influence of education publication-title: Int Psychogeriatr – volume: 12 start-page: 360 issue: 4 year: 2018 end-page: 367 article-title: Influence of age and education on the processing of clustering and switching in verbal fluency tasks publication-title: Dement Neuropsychol – volume: 23 start-page: 75 issue: 2 year: 2016 end-page: 84 article-title: The predictive impact of biological and sociocultural factors on executive processing: the role of age, education, and frequency of reading and writing habits publication-title: Appl Neuropsychol Adult – volume: 68 start-page: 124 issue: 3 year: 2016 end-page: 133 article-title: Verbal fluency tasks: effects of age, gender, and education publication-title: Folia Phoniatr Logop – volume: 7 start-page: 263 issue: 3 year: 2011 end-page: 269 article-title: The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease publication-title: Alzheimers Dement – volume: 24 start-page: 461 issue: 6 year: 2009 end-page: 468 article-title: Longitudinal verbal fluency in normal aging, preclinical, and prevalent Alzheimer’s disease publication-title: Am J Alzheimers Dis Other Demen – volume: 21 start-page: 65 issue: 1 year: 2007 end-page: 67 article-title: Category fluency as a screening test for Alzheimer disease in illiterate and literate patients publication-title: Alzheimer Dis Assoc Disord – volume: 21 start-page: 260 issue: 4 year: 2014 end-page: 268 article-title: Verbal fluency in right brain damage: dissociations among production criteria and duration publication-title: Appl Neuropsychol Adult – volume: 26 start-page: 533 issue: 6 year: 2019 end-page: 542 article-title: Quanti-qualitative components of the semantic verbal fluency test in cognitively healthy controls, mild cognitive impairment, and dementia subtypes publication-title: Appl Neuropsychol Adult – volume: 8 start-page: 323 issue: 3 year: 2001 end-page: 338 article-title: Qualitative analysis of verbal fluency output: Review and comparison of several scoring methods publication-title: Assessment – volume: 37 start-page: 1771 issue: 12 year: 2004 end-page: 1777 article-title: Category fluency test: effects of age, gender and education on total scores, clustering and switching in Brazilian Portuguese-speaking subjects publication-title: Braz J Med Biol Res – volume: 39 start-page: 912 issue: 6 year: 2005 end-page: 917 article-title: Validade da versão em português da Clinical Dementia Rating publication-title: Rev Saude Publica – volume: 44 start-page: 52 issue: 1 year: 2006 end-page: 61 article-title: (Category-specific) semantic deficit in Alzheimer’s patients: the role of semantic distance publication-title: Neuropsychologia – volume: 5 start-page: 772 year: 2014 end-page: 772 article-title: What do verbal fluency tasks measure? Predictors of verbal fluency performance in older adults publication-title: Front Psychol |
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| Title | Verbal fluency in Alzheimer’s disease and mild cognitive impairment in individuals with low educational level and its relationship with reading and writing habits |
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