The Diagnostic Value of Controlled Oral Word Association Test-FAS and Category Fluency in Single-Domain Amnestic Mild Cognitive Impairment

Abstract

Background: Recent studies have shown that decreases in both letter fluency and category fluency may be present in addition to memory impairment in single-domain amnestic mild cognitive impairment (aMCI). However, the clinical utility of these fluency measures is unclear. The aim of this study was to determine what, if any, diagnostic value letter and category fluency provide in differentiating single-domain aMCI from normal cognition. Methods: Data from 66 individuals [33 cognitively normal (CN) and 33 aMCI] between the ages of 66 and 87 years participating in the Florida Alzheimer’s Disease Research Center were compared on the Controlled Oral Word Association Test (COWAT)-FAS and Category Fluency test, both in terms of raw and scaled scores. Results: Participants were matched on age, education and sex. Two-tailed independent sample t-tests found statistically significant differences between the CN and aMCI groups for both raw and scaled scores of COWAT-FAS and Category Fluency (p < 0.001). Logistic regression analyses found that COWAT-FAS and Category Fluency did not significantly improve diagnostic accuracy when combined with the Hopkins Verbal Learning Test-Revised delayed recall. Conclusion: Although decreased COWAT-FAS and Category Fluency performance may be present in single-domain aMCI, these tests do not improve the ability of the Hopkins Verbal Learning Test-Revised delayed recall to differentiate aMCI from CN individuals.