Abstract

ObjectiveVerbal fluency tests are widely used for the assessment of executive functions. However, traditional versions of the test depend on several cognitive factors beyond these components. The aim of this study was to evaluate the associations of a modified version of the verbal fluency with specific measures of executive functions.MethodsSixty adults were evaluated using traditional versions of verbal fluency (animals/fruits) and a modified condition where subjects must switch between animals and fruits. Processing speed, semantic abilities, psychiatric symptoms and executive functions were also assessed.ResultsPartial correlations between the verbal fluency tests and measures of executive functions, controlled for demographic, cognitive and psychiatric symptoms, suggest that cognitive flexibility has 9% shared variance with the verbal fluency test – category animals, 2 % with category fruits, 8% with total words in switching condition, and 20% with total correct word-pairs produced in switching condition. The other aspects of executive functions during the task had shared variance of between 1% and 7% with the verbal fluency tasks.ConclusionThe results suggest that correct word-pairs produced in switching verbal fluency may be a more specific measure for evaluating cognitive flexibility compared to other versions of verbal fluency.

Highlights

  • Executive functions are top-down cognitive processes related to the control of behavior and other cognitive functions.[1]

  • Diamond[2] proposed a model of executive functions characterized by three basic processes: working memory – related to mental manipulation of information; inhibitory control – related to the inhibition of thought, behavior and attentional distractors; and cognitive flexibility – related to switching between tasks or actions and creative thinking. The assessment of these functions is one of the most important points of neuropsychological assessment, since the integrity of the executive function is closely linked to functional outcomes such as school performance,[3] labor capacity,[4] activities of daily living[5] and quality of life.[6]

  • The results of the association analysis suggest that the number of pairs produced in the adapted alternating verbal fluency test is more strongly associated with executive functions, cognitive flexibility, than the traditional versions or the full words produced in the alternating version

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Summary

Introduction

Executive functions are top-down cognitive processes related to the control of behavior and other cognitive functions.[1] In a recent review, Diamond[2] proposed a model of executive functions characterized by three basic processes: working memory – related to mental manipulation of information; inhibitory control – related to the inhibition of thought, behavior and attentional distractors; and cognitive flexibility – related to switching between tasks or actions and creative thinking. Regarding anatomical and clinical correlates, these tasks are commonly associated with prefrontal regions of the left hemisphere in studies involving functional neuroimaging[8] and brain-damaged patients.[9]

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