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Verbal fluency as a screening tool for mild cognitive impairment

Published online by Cambridge University Press:  01 July 2019

Michelle McDonnell Open the ORCID record for Michelle McDonnell [Opens in a new window] ,
Lauren Dill ,
Stella Panos ,
Stacy Amano ,
Warren Brown ,
Shadee Giurgius ,
Gary Small  and
Karen Miller
Michelle McDonnell
Affiliation:
Loma Linda VA Healthcare System, Loma Linda, CA, USA
Lauren Dill
Affiliation:
VA Long Beach Healthcare System, Long Beach, CA, USA
Stella Panos
Affiliation:
UCLA Longevity Center, Los Angeles, CA, USA Cedars-Sinai Medical Center, Los Angeles, CA, USA
Stacy Amano
Affiliation:
Fuller Graduate School of Psychology, Pasadena, CA, USA
Warren Brown
Affiliation:
Fuller Graduate School of Psychology, Pasadena, CA, USA
Shadee Giurgius
Affiliation:
Adult & Geriatric Psychiatry in La Mirada, La Mirada, CA, USA
Gary Small
Affiliation:
UCLA Longevity Center, Los Angeles, CA, USA
Karen Miller*
Affiliation:
UCLA Longevity Center, Los Angeles, CA, USA
*
*Correspondence should be addressed to: Karen Miller, UCLA Longevity Center, 10945 Le Conte Avenue, Suite 3119, Los Angeles, CA90095-6980, USA. Phone: 310-267-2663; Fax: 310-794-0681. Email: [email protected].
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Abstract

Objectives:

The goal of this study was to evaluate the ability of semantic (animal naming) and phonemic (FAS) fluency in their ability to discriminate between normal aging, amnestic-Mild Cognitive Impairment (a-MCI), and Alzheimer’s disease (AD).

Design:

We used binary logistic regressions, multinomial regressions, and discriminant analysis to evaluate the predictive value of semantic and phonemic fluency in regards to specific diagnostic classifications.

Setting:

Outpatient geriatric neuropsychology clinic.

Participants:

232 participants (normal aging = 99, a-MCI = 90, AD = 43; mean age = 65.75 years).

Measurements:

Mini-mental State Examination (MMSE), Controlled Oral Word Association Test

Results:

Results indicate that semantic and phonemic fluency were significant predictors of diagnostic classification, and semantic fluency explained a greater amount of the discriminant ability of the model.

Conclusions:

These results suggest that verbal fluency, particularly semantic fluency, may be an accurate and efficient tool in screening for early dementia in time-limited medical settings.

Keywords

dementiamild cognitive impairmentAlzheimer’s diseasescreening
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 9: Issue Theme: Enhanced Assessment Instruments for Older Adults with Major Neurocognitive Disorders , September 2020 , pp. 1055 - 1062
Copyright
© International Psychogeriatric Association 2019

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References

Albert, M. S.et al. (2011). 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. Alzheimer’s & Dementia, 7, 270–279.CrossRefGoogle Scholar
Austin, P. C. and Hux, J. E. (2002). A brief note on overlapping confidence intervals. Journal of Vascular Surgery, 36, 194–195.CrossRefGoogle ScholarPubMed
Benton, A. L. and Hamsher, K. (1976). Multilingual Aphasia Examination (2nd ed). Iowa City, IA: AJA Associates.Google Scholar
Boustani, M.et al. (2005). Implementing a screening and diagnosis program for dementia in primary care. Journal of General Internal Medicine, 20, 572–577.CrossRefGoogle ScholarPubMed
Boustani, M., Peterson, B., Hanson, L., Harris, R. and Lohr, K. (2003). Screening for dementia in primary care: a summary of the Evidence for the U.S. preventive services task force. Annals of Internal Medicine, 138, 927–942.CrossRefGoogle ScholarPubMed
Chan, A., Butters, N., Salmon, D. P. and McGuire, K. (1993). Dimensionality and clustering in the semantic network of patients with Alzheimer’s disease. Psychology and Aging, 8, 411–419.CrossRefGoogle ScholarPubMed
Clark, L. J., Gatz, M., Zheng, L., Chen, Y. L., McCleary, C. and Mack, W. J. (2009). Longitudinal verbal fluency in normal aging, preclinical, and prevalent Alzheimer’s disease. American Journal of Alzheimer’s Disease & Other Dementia, 24, 461–468.CrossRefGoogle ScholarPubMed
Crook, T., Bartus, R. T., Ferris, S. H., Whitehouse, P., Cohen, G. D. and Gershon, S. (1986). Age-associated memory impairment: proposed diagnostic criteria and measures of clinical change—report of a National Institute of Mental Health work group. Developmental Neuropsychology, 2, 261–276.CrossRefGoogle Scholar
Fama, R.et al. (2000). Structural brain correlates of verbal and nonverbal fluency measures in Alzheimer’s disease. Neuropsychology, 14, 29–40.CrossRefGoogle ScholarPubMed
Fischer, P.et al. (2007). Conversion from subtypes of mild cognitive impairment to Alzheimer dementia. Neurology, 69, 288–291.CrossRefGoogle Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). Mini-mental state. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Galasko, D., Klauber, M. R., Hofstetter, C. R., Salmon, D. P., Lasker, B. and Thal, L. (1990). The mini-mental state examination in the early diagnosis of Alzheimer’s disease. Archives of Neurology, 47, 49–52.CrossRefGoogle ScholarPubMed
Henry, J. D., Crawford, J. R. and Phillips, L. H. (2004). Verbal fluency performance in dementia of the Alzheimer’s type: a meta-analysis. Neuropsychologia, 42, 1212–1222.CrossRefGoogle ScholarPubMed
Hodges, J. R., Salmon, D. P. and Butters, N. (1992). Semantic memory impairment in Alzheimer’s disease: failure of access or degraded knowledge? Neuropsychologia, 30, 301–314.CrossRefGoogle ScholarPubMed
Jackson, M. D. and Ramsdell, J. W. (1988). Use of the mini-mental state examination (MMSE) to screen for dementia in elderly outpatients. Journal of American Geriatrics Society, 36, 662.Google Scholar
Karas, G.et al. (2008). Amnestic mild cognitive impairment: structural MR imaging findings predictive of conversion to Alzheimer disease. American Journal of Neuroradiology, 29, 944–949.CrossRefGoogle ScholarPubMed
Lehrner, J.et al. (2005). Annual conversion to Alzheimer disease among patients with memory complaints attending an outpatient memory clinic: the influence of amnestic mild cognitive impairment and the predictive value of neuropsychological testing. Wiener Klinische Wochenschrift, 117, 629–635.CrossRefGoogle ScholarPubMed
Leifer, B.P. (2003). Early diagnosis of Alzheimer’s disease: clinical and economic benefits. Journal of the American Geriatrics Society, 51, S281–S288.CrossRefGoogle ScholarPubMed
Lopponen, M., Raiha, I., Isoaho, R., Vahlberg, T. and Kivela, S. (2003). Diagnosing cognitive impairment and dementia in primary health care—a more active approach is needed. Age and Ageing, 32, 606–612.CrossRefGoogle ScholarPubMed
Mitchell, A. J., Meader, N. and Pentzek, M. (2011). Clinical recognition of dementia and cognitive impairment in primary care: a meta-analysis of physician accuracy. Acta Psychiatrica Scandinavica, 124, 165–183.CrossRefGoogle ScholarPubMed
Mitrushina, M. N., Boone, K. B. and D’Elia, L. F. (1999). Verbal fluency test. In Handbook of Normative Data for Neuropsychological Assessment (pp 131–153). New York, NY: Oxford University Press.Google Scholar
Monsch, A. U., Bondi, M. W., Butters, N., Salmn, D., Katzman, R. and Thal, L. J. (1992). Comparisons of verbal fluency tasks in the detection of dementia of the Alzheimer’s type. Archives of Neurology, 49, 1253–1258.CrossRefGoogle Scholar
Moorhouse, P. (2009). Screening for dementia in primary care. The Canadian Review of Alzheimer’s Disease and Other Dementias, 12, 8–13.Google Scholar
Murphy, K. J., Rich, J. B. and Troyer, A. K. (2006). Verbal fluency patterns in amnestic mild cognitive impairment are characteristic of Alzheimer’s type dementia. Journal of the International Neuropsychological Society, 12, 570–574.CrossRefGoogle ScholarPubMed
Nasreddine, Z. S. (2005). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53, 695–699.CrossRefGoogle ScholarPubMed
Newcombe, F. (1969). Missile Wounds of the Brain. London, U.K.: Oxford University Press.Google Scholar
Nutter-Upham, K.et al. (2008). Verbal fluency performance in amnestic MCI and older adults with cognitive complaints. National Academy of Neuropsychology, 23, 229–241.Google ScholarPubMed
Parmar, J.et al. (2014). Diagnosis and management of dementia in primary care: exploratory study. Canadian Family Physician, 60, 457–465.Google ScholarPubMed
Petersen, R. C.et al. (2001). Current concepts in mild cognitive impairment. Archives of Neurology, 58, 1985–1992.CrossRefGoogle ScholarPubMed
Price, S. E.et al. (2012). Semantic verbal fluency strategies in amnestic mild cognitive impairment. Neuropsychology, 26, 490.CrossRefGoogle ScholarPubMed
Rinehardt, E.et al. (2014). Verbal fluency patterns in mild cognitive impairment and Alzheimer’s disease. Dementia and Geriatric Cognitive Disorders, 38, 1–9.CrossRefGoogle ScholarPubMed
Salmon, D., Heindel, W. C. and Lange, K. L. (1999). Differential decline in word generation from phonemic and semantic categories during the course of Alzheimer’s disease: implications for the integrity of semantic memory. Journal of the International Neuropsychological Society, 5, 692–703.CrossRefGoogle ScholarPubMed
Sebaldt, R.et al. (2009). Detection of cognitive impairment and dementia using the animal fluency test: the DECIDE study. The Canadian Journal of Neurological Sciences, 36, 599–604.CrossRefGoogle ScholarPubMed
Strauss, E., Sherman, E. M. S. and Spreen, O. (2006). A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. New York, NY: Oxford University Press.Google Scholar
Tang-Wai, D. F.et al. (2003). Comparison of the short test of mental status and the mini-mental state examination in mild cognitive impairment. Archives of Neurology, 60, 1777–1781.CrossRefGoogle ScholarPubMed