Abstract
The semantic verbal fluency task is broadly used in the neuropsychological assessment of elderly subjects. Even some studies have identified differences in verbal fluency clustering and switching measures between subjects with normal aging and a clinical condition such as mild cognitive impairment (MCI) and Alzheimer's disease, the results are not always consistent. This study aimed to compare clustering and switching measures of an animal's semantic verbal fluency task among normal controls (NC, n = 25), amnestic mild cognitive impairment (aMCI; n = 25), amnestic multiple domain Mild Cognitive Impairment (a+mdMCI; n = 25) and Alzheimer's disease (AD; n = 25) Brazilian subjects. The analyses were executed considering three (unifying the MCI subtypes) and four groups. As the data were not normally distributed, we carried out non-parametric tests (Kruskal-Wallis and Mann-Whitney tests) to evaluate the differences in performance in the measures of the verbal fluency test among the groups. The comparison demonstrated that the groups differed in the total of correct words produced, number of clusters and switching but the measure of new subcategories was the only with significant difference among the NC and all the clinical groups. The measure of new subcategories is the number of original subcategories inside the higher category of animals that the subject produced, such as farm, domestic, African animals. Our results indicate that semantic memory impairment is a visible and recent deficit that occurs even in non-demented subjects with very MCI and the implications of these findings are discussed.
Highlights
Mild cognitive impairment (MCI) is common among older adults with prevalence estimates ranging from 3 to 42% (Yesavage et al, 2002; Ward et al, 2012), and subjects with MCI have increased risk of developing dementia (Han et al, 2012)
As Semantic verbal fluency (SVF) is commonly used in clinical practice and the analysis of other aspects of this task can add important information on the cognitive status of a patient, we aim to evaluate whether measures of clustering, switching, and number of subcategories can help to distinguish MCI and Alzheimer’s disease (AD) patients from healthy older adults with no cognitive decline
NC, MCI, AD The AD, MCI, and control participants did not differ in most demographic data, except that the normal control group showed a significant higher frequency of women according to the Chisquare test (X2 = 6.76, df = 2, p = 0.009)
Summary
Mild cognitive impairment (MCI) is common among older adults with prevalence estimates ranging from 3 to 42% (Yesavage et al, 2002; Ward et al, 2012), and subjects with MCI have increased risk of developing dementia (Han et al, 2012). Neuropsychological assessments are expensive, time-consuming, need highly trained professionals to do and, may not be readily available in clinical practice. Cognitive screening tests are widely available, have low costs and need no specialized training for its correct administration and interpretation of results. Though being routinely used in clinical practice to evaluate subjects with cognitive complaints, they are not sensitive to identify mild cognitive deficits (Diniz et al, 2007). As a consequence many older adults may not be correctly identified as MCI delaying the diagnosis until they reach the threshold for dementia
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