Phonemic Fluency Tasks Research Articles

Characteristics of Clustering and Switching in Verbal Fluency in Mild Cognitive Impairment and Dementia of Alzheimer’s Type

Objectives: The purpose of this study was to compare the performance on a verbal fluency task, clustering and switching characteristics, and proportion by error type between healthy elderly, Mild Cognitive Impairment (MCI) and Dementia of Alzheimer’s Type (DAT) group. Methods: Thirty healthy elderly, 30 MCI and 29 DAT individuals were asked to produce words in the category of ‘supermarket items’ for semantic fluency and ‘ㄱ’, ‘ㅇ’, and ‘ㅅ’ Korean letter categories for phonemic fluency with one minute allotted per category. Results: First, the number of correct responses in the verbal fluency task was significantly different between groups, with post hoc analyses showing significant differences between the healthy elderly and DAT groups and between the MCI and DAT groups. Second, the mean cluster size was not significant between groups in the semantic fluency task. However, it was significant between the healthy elderly and DAT groups, and between MCI and DAT groups in the phonemic fluency task. Third, the number of switches was significant between the healthy elderly and DAT elderly. Finally, the three groups had the highest proportion of perseverative errors in the semantic fluency task and the highest proportion of other errors in the phonemic fluency task. Conclusion: This study has clinical significance in that it examined the number of correct responses and characteristics of clustering and switching on verbal fluency tasks in the healthy elderly, MCI and DAT groups.

A - 121 A Comparison of Phonemic and Semantic Fluency among Individuals with Vascular Encephalopathy (VaE), Alzheimer’s Disease (ad), and Healthy Controls (HC)

Abstract Objective To examine the performance of individuals with vascular encephalopathy, Alzheimer’s disease, and healthy controls on phonemic and semantic fluency tasks. Method Participants (N = 485) were categorized based on their diagnosis: VAE (n = 129, Mage = 76, 54.26% male); ad (n = 191, Mage = 75.67, 31.41% male); and HC (n = 165, Mage = 69, 26.67% male). Quade ANCOVAs were employed to probe differences in phonemic fluency and semantic fluency across the three groups while accounting for age and education. Results Statistically significant findings were observed for the overall model for phonemic and semantic fluency, indicating strong relationships between diagnosis and task performance (Phonemic: F(4, 480) = 115.017, p < 0.001, ηp2 = 0.489; Semantic F(4, 480) = 280.779, p < 0.001, ηp2 = 0.701). A contrast analysis revealed significant differences when comparing ad to HC [Phonemic: -165.300 (SE = 12.512, t = −13.21, p < 0.001); Semantic −238.003 (SE = 9.583; t = −24.83, p < 0.001)]. A similar pattern emerged when comparing the VAE and HC groups [Phonemic: -126.471 (SE = 13.833, t = −9.14, p < 0.001); Semantic −181.446 (SE = 10.595, t = −17.12, p < 0.001)]. Conclusion Cognitive impairment type significantly influenced phonemic and semantic fluency scores, even after adjusting for age and education. ad individuals showed the lowest performance in both tasks compared to VaE individuals, who in turn performed worse than HCs. Assessing differences in phonemic and semantic fluency between disease groups is crucial for differential diagnosis and understanding specific cognitive deficits, which can guide personalized treatment strategies. These evaluations help monitor disease progression and contribute to research that may lead to improved therapeutic approaches.

Chinese Verbal Fluency Deficiency in Temporal Lobe Epilepsy with and without Hippocampal Sclerosis: A Multiscale Study.

To test a Chinese character version of the phonemic verbal fluency task in patients with temporal lobe epilepsy (TLE) and assess the verbal fluency deficiency pattern in TLE with and without hippocampal sclerosis, a cross-sectional study was conducted including 30 patients with TLE and hippocampal sclerosis (TLE-HS), 28 patients with TLE and without hippocampal sclerosis (TLE-NHS), and 29 demographically matched healthy controls (HC). Both sexes were enrolled. Participants finished a Chinese character verbal fluency (VFC) task during functional MRI. The activation/deactivation maps, functional connectivity, degree centrality, and community features of the left frontal and temporal regions were compared. A neural network classification model was applied to differentiate TLE-HS and TLE-NHS using functional statistics. The VFC scores were correlated with semantic fluency in HC while correlated with phonemic fluency in TLE-NHS. Activation and deactivation deficiency was observed in TLE-HS and TLE-NHS (p < 0.001, k ≥ 10). Functional connectivity, degree centrality, and community features of anterior inferior temporal gyri were impaired in TLE-HS and retained or even enhanced in TLE-NHS (p < 0.05, FDR-corrected). The functional connectivity was correlated with phonemic fluency (p < 0.05, FDR-corrected). The neural network classification reached an area under the curve of 0.90 in diagnosing hippocampal sclerosis. The VFC task is a Chinese phonemic verbal fluency task suitable for clinical application in TLE. During the VFC task, functional connectivity of phonemic circuits was impaired in TLE-HS and was enhanced in TLE-NHS, representing a compensative phonemic searching strategy applied by patients with TLE-NHS.

The Contributions of the Cerebellar Peduncles and the Frontal Aslant Tract in Mediating Speech Fluency.

Fluent speech production is a complex task that spans multiple processes, from conceptual framing and lexical access, through phonological encoding, to articulatory control. For the most part, imaging studies portraying the neural correlates of speech fluency tend to examine clinical populations sustaining speech impairments and focus on either lexical access or articulatory control, but not both. Here, we evaluated the contribution of the cerebellar peduncles to speech fluency by measuring the different components of the process in a sample of 45 neurotypical adults. Participants underwent an unstructured interview to assess their natural speaking rate and articulation rate, and completed timed semantic and phonemic fluency tasks to assess their verbal fluency. Diffusion magnetic resonance imaging with probabilistic tractography was used to segment the bilateral cerebellar peduncles (CPs) and frontal aslant tract (FAT), previously associated with speech production in clinical populations. Our results demonstrate distinct patterns of white matter associations with different fluency components. Specifically, verbal fluency is associated with the right superior CP, whereas speaking rate is associated with the right middle CP and bilateral FAT. No association is found with articulation rate in these pathways, in contrast to previous findings in persons who stutter. Our findings support the contribution of the cerebellum to aspects of speech production that go beyond articulatory control, such as lexical access, pragmatic or syntactic generation. Further, we demonstrate that distinct cerebellar pathways dissociate different components of speech fluency in neurotypical speakers.

Psycholinguistics Study on the Interplay of Bilingualism on Selected Cognitive Functions Based on Threshold Hypotheses among Saudi International School Students

This study investigates the threshold hypothesis in Saudi international school students. While this hypothesis has been extensively researched in the West, its application in Arabic-speaking regions, particularly Saudi Arabia, remains unexplored. This paper compares the executive function (metalinguistic awareness, inhibitory control, attentional control, and working memory) differences between the three levels of bilinguals (balanced, dominant, and semi) in male secondary school students in Saudi Arabia. Participants took language tests (TOEFL for English, GCSE for Arabic) and four cognitive tasks (grammatical judgment task, Stroop Task, semantic and phonemic fluency task, and Backward-digit-recall task). A quantitative causal-comparative analysis concluded that there was no significant difference between the performance of balanced, dominant, and semi-bilinguals on executive function tasks, except for the phonemic task. However, the study showed that semi-bilinguals performed poorly in all cognitive tasks. Thus, balanced and dominant bilinguals perform equally in inhibitory control, mental flexibility, and metalinguistic and semantic tasks.

Phonemic verbal fluency in non-WEIRD populations: Demographic differences in performance in the Controlled Oral Word Association Test-FAS

This study aimed to investigate whether age, level of education, gender, number of spoken languages, and the self-reported position of language within this multilingual experience predicted performance on the Controlled Oral Word Association Test (COWAT-FAS). Using a cross-sectional research design, the phonemic verbal fluency of a sample (n = 156) of healthy adults (ages 18–60 years) with different linguistic and educational backgrounds from a non-WEIRD (western, educated, industrialised, rich and democratic) context was assessed using the COWAT-FAS (including the F, A, S, total correct, repetition, incorrect, and total errors). Pearson’s correlations showed significant negative associations between age and most of the COWAT scores, including the total (r = –0.47; p 0.01) and significant positive associations between years of education and all of the COWAT scores, including the total (r = 0.49; p 0.01). The number of languages spoken was not significantly correlated with any of the COWAT scores, but multilinguals who identified English as a first language performed significantly better than those who identified English as a secondary language for several COWAT scores, including the total (t154 = 3.85; p 0.001; d = 0.79). Age (B = –0.32; p 0.001), years of education (B = 0.35; p 0.001), and language position (B = –0.20; p 0.01) also significantly predicted the COWAT total score (r2 = 0.38; F = 18.34; p 0.001; f2 = 0.61). The implications of these findings for use of the COWAT-FAS in multilingual and non-WEIRD contexts are discussed.Contribution: This article supports the importance of understanding the role demographic variables play in cognitive performance and how they represent a source of bias in cognitive testing, particularly in the COWAT-FAS. It highlights how age, level of education, and the correspondence, or lack thereof, between first language and language of assessment, impacts phonemic fluency tasks. This knowledge may help to manage biases when conducting verbal fluency assessments with multilingual individuals and in non-WEIRD contexts.

Enhancement of phonemic verbal fluency in multilingual young adults by transcranial random noise stimulation

Several studies have analyzed the effects of transcranial direct current stimulation on verbal fluency tasks in non-clinical populations. Nevertheless, the reported effects on verbal fluency are inconsistent. In addition, the effect of other techniques such as transcranial random noise stimulation (tRNS) on verbal fluency enhancement has yet to be studied in healthy multilingual populations. This study aims to explore the effects of tRNS on verbal fluency in healthy multilingual individuals. Fifty healthy multilingual (Spanish, English and Basque) adults were randomly assigned to a tRNS or sham group. Electrodes were placed on the left dorsolateral prefrontal cortex and left inferior frontal gyrus. All participants performed phonemic and semantic verbal fluency tasks before, during (online assessment) and immediately after (offline assessment) stimulation in three different languages. The results showed significantly better performance by participants who received tRNS in the phonemic verbal fluency tasks in Spanish (in the online and offline assessment) and English (in the offline assessment). No differences between conditions were found in Basque nor semantic verbal fluency. These findings suggests that tRNS on the left prefrontal cortex could help improve phonemic, yet not semantic, fluency in healthy multilingual adults.

Transdiagnostic Analysis of Verbal Fluency across Autism Spectrum Disorder, Schizophrenia, and Neurotypical Healthy Control Groups

IntroductionVerbal fluency, a cognitive function that reflects executive functions and the rapid retrieval of pertinent information from memory, has yielded inconsistent findings in previous research on autism spectrum disorder (ASD), however in schizophrenia (SCH) semantic fluency exhibits a more pronounced impairment compared to letter fluency.ObjectivesIn this study we aim to comprehensively investigate verbal fluency in ASD, SCH, and neurotypical healthy control individuals (NTP). The primary objective is to investigate disparities in novel response generation, specifically between the ASD, SCH and NTP groups, using phonemic and semantic fluency tasks. Three central inquiries guide our research: (1) whether differences between groups (ASD, SCH, and NTP) can be identified in word productivity, clustering, errors, and perseverations; (2) whether participants with ASD and SCH exhibit different word production with elevated imageability and concreteness values; and (3) if individuals with ASD and schizophrenia demonstrate reduced productivity during the earlier phases of fluency tasks.MethodsForty participants with ASD (12 female, 24 male, 4 other, mean age: 30.5), 39 with SCH (10 female, 28 male, 1 other, mean age: 34.7) and 41 NTP (13 female, 28 male, mean age: 31.0) were recruited from the outpatient units of the Department of Psychiatry and Psychotherapy, Semmelweis University. Participants were requested to list as many words as they could on two phonemic and two semantic category conditions. Audio recordings were later transcribed. To assess concreteness and imageability, we employed a seven-point scale and recruited independent external raters to evaluate a total of 1481 words.ResultsPreliminary results indicate that the three study groups did not differ significantly in phonemic fluency (F(2, 119)= 0.983, p=0.377), during either time period. However, a significant difference was observed in semantic fluency (F(2, 119)= 6.531, p=0.002). Post-hoc tests (Tukey corrected) revealed that this difference stemmed from impaired performance in the SCH group. Participants with schizophrenia (SCH) exhibited reduced semantic word productivity compared to both neurotypical (NTP) individuals and participants with ASD (Figure 1). However, there were no significant differences between participants with ASD and NTP individuals.Image:ConclusionsIn conclusion, our study investigated the characteristics of verbal fluency in a transdiagnostic approach. While phonemic fluency did not reveal significant differences among the three groups, our analysis of semantic fluency unveiled a distinction. Specifically, individuals with schizophrenia exhibited impaired semantic word productivity. Our study highlights the complex nature of verbal fluency impairments in different conditions and the importance of considering more nuanced methods when assessing cognitive functions.Disclosure of InterestNone Declared

Profiling word retrieval abilities in persons with aphasia - A preliminary study

Various methods are used to elicit the naming responses. The current study aimed to assess different naming abilities in persons with aphasia. Naming abilities were assessed using varied types of naming tasks for PWA. PWA was subjected to eight types of naming tasks [Confrontation Naming (CN), Phonemic Fluency (PF), Semantic Fluency (SF), Serial Naming (SN), Ordinate Naming (ON), Automated Naming (AN), Responsive Naming (RN) and Sentence Completion (SC)] and compared with age, education matched neurotypical individuals (n=15). The assessment was carried out in the Kannada Language. The raw scores obtained for each task were tabulated and subjected to statistical analysis. On eight naming tasks, neurotypical individuals performed better than persons with post-stroke aphasia. Mann Whitney U test revealed a significant difference in the phonemic fluency task in both groups of participants with a value less than 0.05. Friedman analysis with adjusted Bonferroni showed a significant difference in pairwise comparison for eight naming tasks. Among which pairs with phonemic fluency task had a significant difference in both the groups (p&lt; 0.05). The correlation between language impairment in PWA and types of naming was studied using WAB AQ scores with accuracy scores on different types of naming tasks. A significant correlation was seen between WAB AQ and the Phonemic fluency task. The nature of the task and the factors affecting the naming of each task influence the performance of the individuals. PWA has a difference in brain mechanism for naming compared to NTI. Phonemic fluency is recommended for regular naming assessments as it is simple, easy, and quick to administer. Also, it taps both the cognitive and linguistic abilities of an individual. Language impairment and different types of naming are well related in the current study. The need to assess all types of naming to understand the word production deficit is justified.

Utility of a Short-Form Phonemic Fluency Task.

to establish a proof-of-concept and ascertain the reliability of an abbreviated 30-second (30s) phonemic fluency measure as a cognitive screening tool in older adults. in all, 201 English-speaking individuals with normal cognition (NC; n = 119) or cognitive impairment (CI; mild CI or dementia; n = 82) were administered a standard 60s phonemic fluency task (FAS/CFL) with discrete 30s intervals denoted. for all letters, 30s trial scores significantly predicted 60s scores for the same letter, R2 = .7-.9, F(1, 200) = 850-915, p < .001. As with 60s total scores, 30s cumulative scores (for all three trials) were significantly different between NC and CI groups (p < .001). Receiver operating characteristic analyses showed that 30s total scores distinguished NC and CI groups as effectively (AUC = .675) as 60s total scores (AUC = .658). these findings support the utility and reliability of a short-form phonemic fluency paradigm, as 30s performance reliably predicted 60s/trial totals and was equally accurate in distinguishing impaired/non-impaired groups.

Reliability of clinical judgment for evaluation of informed consent in mental health settings and the validation of the Evaluation of Informed Consent to Treatment (EICT) scale.

The competence assessment to give informed consent in the legal and healthcare settings is often performed merely through clinical judgment. Given the acknowledged limited reliability of clinician-based evaluation in the mental health sector, particularly for the assessment of competence to consent, our objective was to ascertain the dependability of clinical judgment when evaluating the ability of schizophrenia patients to make choices about their health. The potential convergence between clinical evaluation and scores from a new standardized assessment (the "Evaluation of Informed Consent to Treatment" - "EICT" scale) was therefore tested. The scale assesses four dimensions of competence, specifically how patients normally understand information relating to care (Understanding); how they evaluate the choice of treatment in terms of risk/benefit ratio (Evaluating); how they reason coherently in the decision-making process (Reasoning); and, finally, their ability to make a choice between treatment alternatives (Expressing a choice). Thirty-four outpatients with schizophrenia were evaluated for their competence to consent by five referring clinicians with different backgrounds (psychiatrist, forensic psychiatrist, geriatrician, anesthetist, and medico-legal doctor). Inter-raters variability was tested through correlation analyses between the scores obtained by the clinicians on a modified version of the Global Assessment of Functioning scale (GAF) designed specifically to subjectively assess functioning in each of the four competence dimensions. Two validated competence scales (Mac-CAT-T, SICIATRI-R), and a neuropsychological battery were also administered along with scales for evaluating neuropsychiatric symptoms severity and side effects of medication. Clinical judgments of the individual specialists showed great inter-rater variability. Likewise, only weak/non-significant correlations were found between the EICT subscales and the respective clinicians-rated GAF scales. Conversely, solid correlations were found between the EICT and MacCAT-T subscales. As expected, healthy controls performed better in the ability to give informed consent to treatment, as measured by the three scales (i.e., EICT, MacCAT-T, and SICIATRI-R), and neuropsychological test performance. In the comparisons between patients who, according to the administered EICT, were able or not able to give informed consent to treatment, significant differences emerged for the Phonemic verbal fluency task (p = 0.038), Verbal judgments (p = 0.048), MacCAT-T subscales, and SICIATRI-R total score. Moreover, EICT exhibited excellent internal consistency (Cronbach's alphas ranging from 0.96 to 0.98 for the four subscales) while the Item Analysis, by measuring the correlation between each item of the EICT and the total score, was excellent for all items of all subscales (alphas ranging from 0.86 to 0.98). In conclusion, our findings highlighted that the assessment of competence exclusively through clinical judgment is not fully reliable and needs the support of standardized tools. The EICT scale could therefore be useful in assessing general competence to consent both in healthcare and legal contexts, where it might be necessary to evaluate the effective competence of patients with psychiatric disorders. Finally, this scale could serve as a valuable tool for decisions regarding whether and to what extent a patient needs support.

Executive and memory dysfunction related to binge drinking in stroke survivors during a 9-year follow-up.

Ischemic stroke and heavy alcohol consumption are both known risk factors for cognitive impairment. The issue gains importance because the prevalence of stroke and binge drinking have both increased among working-aged adults. Alarmingly, a recent cross-sectional study suggests the additive negative effects of binge drinking and comorbid brain disease on cognition. However, the long-term cognitive prognosis of the additive effects of stroke and binge drinking on adults remains unknown. In this prospective, two-center cohort study, we recruited consecutive 18-65-year-old patients with first-ever ischemic stroke along with demographically matched stroke-free controls. Patients participated in neuropsychological assessment at 6 months, 2 years, and 9 years after stroke, and in neurological assessment at acute care and at 9-year follow-up. Controls participated in a similar follow-up procedure. We examined the association between binge drinking, follow-up time, and long-term cognitive outcomes using repeated-measures analysis of variance. We included 85 patients who had had their first-ever and only ischemic stroke (mean age 53 years at the incident stroke). Patients were divided into binge-drinking (n = 22) and non-binge-drinking groups (n = 63) based on the shortened version of the Alcohol Use Disorders Identification Test. Follow-up data in healthy controls (n = 31) was used to normalize the patients' test scores for effects of age, sex, and education. We compared cognitive changes between binge-drinking and non-binge-drinking patients over a 9-year follow-up. Non-binge-drinking patients outperformed binge-drinking patients across all follow-up points on most of the executive function tests and in one memory test: binge drinking had a significant main effect both on executive function (the phonemic fluency task, p = 0.002; the Trail Making Test, p = 0.013) and memory (the list learning task, p = 0.002). Binge drinking was associated with executive and memory dysfunction at three time points over a decade after a first-ever ischemic stroke. Subdiagnostic binge drinking might increase the adverse effects of a first-ever ischemic stroke on executive function and memory, evident over a decade poststroke.

The importance of response times measures in verbal fluency tasks

Verbal fluency is a commonly used task in clinical and experimental neuropsychology. It assesses a person’s ability to generate relevant words, according to a given category within a limited amount of time. Phonemic (PF) and semantic (SF) fluency tasks reflect different aspects of language and executive function abilities. In the present study, we investigated first response latency as an additional measure of phonemic, semantic and excluded letter fluency of 44 healthy adults (aged 18 to 39 years old) divided in 2 groups, according to their education level. We investigated potential correlations between response times and education level. Preliminary results from a small sample show that when comparing phonemic, semantic and excluded letter tasks the shortest response time was observed in semantic fluency tasks whereas the excluded letter tasks have the longest (Z = -5.35, p &lt; 0.0005). Education appeared to have a significant negative effect on the mean response times of the participants (for PF U = 137, p = 0.014; for ELF U = 141.5, p = 0.018; for SF t = 2.05, p = 0.046). These results constitute a potential underexamined way to investigate lexical organization and access in verbal fluency. Also, we noted that education contributes not only to overall performance but to response times as well.

Structural brain morphometry differences and similarities between young patients with Crohn's disease in remission and healthy young and old controls.

Crohn's disease (CD), one of the main phenotypes of inflammatory bowel disease (IBD), can affect any part of the gastrointestinal tract. It can impact the function of gastrointestinal secretions, as well as increasing the intestinal permeability leading to an aberrant immunological response and subsequent intestinal inflammation. Studies have reported anatomical and functional brain changes in Crohn's Disease patients (CDs), possibly due to increased inflammatory markers and microglial cells that play key roles in communicating between the brain, gut, and systemic immune system. To date, no studies have demonstrated similarities between morphological brain changes seen in IBD and brain morphometry observed in older healthy controls.. For the present study, twelve young CDs in remission (M = 26.08 years, SD = 4.9 years, 7 male) were recruited from an IBD Clinic. Data from 12 young age-matched healthy controls (HCs) (24.5 years, SD = 3.6 years, 8 male) and 12 older HCs (59 years, SD = 8 years, 8 male), previously collected for a different study under a similar MR protocol, were analyzed as controls. T1 weighted images and structural image processing techniques were used to extract surface-based brain measures, to test our hypothesis that young CDs have different brain surface morphometry than their age-matched young HCs and furthermore, appear more similar to older HCs. The phonemic verbal fluency (VF) task (the Controlled Oral Word Association Test, COWAT) (Benton, 1976) was administered to test verbal cognitive ability and executive control. On the whole, CDs had more brain regions with differences in brain morphometry measures when compared to the young HCs as compared to the old HCs, suggesting that CD has an effect on the brain that makes it appear more similar to old HCs. Additionally, our study demonstrates this atypical brain morphometry is associated with function on a cognitive task. These results suggest that even younger CDs may be showing some evidence of structural brain changes that demonstrate increased resemblance to older HC brains rather than their similarly aged healthy counterparts.

Verbal fluency patterns associated with the amnestic conversion from mild cognitive impairment to dementia

Patients with amnestic mild cognitive impairment (aMCI) are at a higher risk of converting to Alzheimer's disease. The aim of this study was to examine the potential use of Verbal Fluency (VF) measures as markers for predicting the conversion to dementia. At baseline, 61 aMCI, aged 65 to 80 years, underwent a comprehensive neuropsychological assessment, including phonemic (PVF) and semantic verbal fluency (SVF) tasks. After 18 months, 14 individuals with aMCI had progressed to a diagnosis of dementia. The findings revealed that aMCI-converter group had lower Mini Mental State Examination and Rey Auditory Verbal Learning Task scores than aMCI-no converter and produced fewer clusters in both VF tasks and a lower number of switches in PVF at baseline (p < 0.05). According to receiver operating characteristic curve analysis, the number of clusters in PVF had the highest predictive value (AUC = 0.80) with a threshold of 5.510 for identifying aMCI-converter at baseline. Additionally, participants with higher levels of education exhibited more clusters and switches in VF tasks (p < 0.05). These results suggest that qualitative measures of VF could serve as neuropsychological markers for predicting cognitive decline in individuals with aMCI. Furthermore, the study highlights the potential influence of the education level on cognitive performance in neuropsychological tasks.

High School and Beyond: Cohort Data for Studying the Effects of Education on Midlife Cognition

AbstractBackgroundThe objective of our presentation is to describe the utility of data from the High School and Beyond (HSB) cohort for studying the impact of early life circumstances and experiences—especially related to education—on risk of midlife cognitive impairment. HSB is a cohort study of a large (n∼25,500), diverse, nationally‐representative probability sample of American high school students in 1980. Participants were surveyed in 1980, 1982, 1984, 1986, 1992, and 2014/2015 with high rates of response; teachers and school administrators were also surveyed, and transcripts provide information about secondary and postsecondary course taking. HSB data from 1980 through 1992 include detailed information about educational contexts, opportunities, and outcomes as well as about family circumstances, labor force activities, and other early life factors.MethodA 2021/2022 follow‐up survey with surviving cohort members featured lengthy interviews; a home health visit that included blood and saliva collection and anthropometric measures; and linkages to administrative records (e.g., mortality records, prescription records). Interviews included immediate and delayed recall tasks; a phonemic fluency task; a semantic fluency task; working memory tasks; self‐reported memory complaints; and detailed information about health conditions.ResultOf the ∼24,330 surviving HSB panelists, ∼13,900 completed surveys in 2021/2022. Of the ∼13,900 sample members completing surveys, ∼4,880 completed a home health visit; an additional ∼1,560 mailed back saliva kits. HSB ultimately received ∼4,430 blood samples by the time fieldwork concluded in late 2022. Blood collected in 2022 is being used to construct (1) measures that define the main pathological features of ADRD (e.g., Aβ42, Aβ40, p‐tau 181, total tau, NFL, and gFAP); (2) measures that reflect cognition‐relevant pathologies (e.g., hemoglobin A1c, inflammatory markers, markers of endothelial function, markers of blood‐brain barrier disfunction, and blood lead levels); and (3) measures of biological aging (e.g., the GrimAge clock, DunedinPACE pace of aging, the Hannum clock).ConclusionHSB is now an extraordinary resource for studying—using a large, diverse national sample—the effects of educational contexts, opportunities, and outcomes on midlife cognitive functioning and biological markers of ADRD risk.

Repurposing verbal fluency: Word‐property analysis reveals neurocognitive markers of Hispanics with Alzheimer’s disease and mild cognitive impairment

AbstractBackgroundThough central to dementia assessments, verbal fluency tasks are suboptimally exploited. Performance is typically measured by counting valid responses. This precludes insights on which word types are least accessible to patients, while failing to discriminate among disorders. Alternatively, each word can be decomposed into relevant properties that drive semantic memory retrievability. Recently, our team has combined objective lexical measures with multimodal imaging to examine whether this approach is sensitive to Hispanics with Alzheimer’s disease (AD) and mild cognitive impairment (MCI), vis‐à‐vis others with behavioral variant frontotemporal dementia (bvFTD).MethodIn Experiment‐1, we recruited 32 AD patients and 32 bvFTD patients, matched with 27 HCs. Experiment‐2 involved 60 persons with MCI and 60 matched HCs. Participants performed phonemic and semantic fluency tasks. We counted valid responses and, using normative databases, extracted quantitative data of six word properties: frequency (occurrences in everyday use), granularity (conceptual specificity), neighborhood (words with similar phonological structure), length (number of syllables), familiarity (subjective recognizability), and imageability (ease of mental visualization). We examined whether these variables were robust to discriminate between groups (via ANOVAs), identify individuals from each cohort (via linear regressions), and capture cognitive, neuroanatomical, and functional connectivity disruptions.ResultsIn Experiment‐1, while both patient groups produced fewer valid responses than HCs, only AD patients showed distinct word properties (higher frequency, lower granularity, more phonological neighbors). Multivariate word properties robustly identified individual AD (but not bvFTD) patients from HCs (AUC = .89), driven by the abovementioned properties. These features correlated with executive outcomes only in AD, and they predicted patients’ anatomical and functional disruptions along temporal, frontal, and cingulate regions. In Experiment‐2, the same word properties differentiated MCI individuals from HCs, with multivariate classification reaching an AUC of .75. These features correlated with the volume of, and connectivity between, temporal and frontal regions that partly overlapped with those observed in AD.ConclusionVerbal fluency tasks can be repurposed to reveal condition‐specific markers of persons with and at increased risk for AD. New avenues emerge towards scalable, low‐cost assessment of Hispanics and, potentially, other underrepresented populations.

Optimising speech‐testing to predict prodromal Alzheimer’s disease: head‐to‐head comparison study of tasks and analysis methods

AbstractBackgroundChanges in speech occur in early‐stage Alzheimer’s disease. A range of approaches have been used for eliciting and automatically analysing speech, but limited research has directly compared these methods.MethodParticipants from the AMYPRED‐UK (NCT04828122) and AMYPRED‐US (NCT04928976) studies completed four speech‐elicitation tasks: the Automatic Story Recall Task (ASRT), the Logical Memory Test (LMT), Semantic (Animals, Vegetables, Fruit) and Phonemic Verbal Fluency (F, A, S) Tasks. Responses were recorded and automatically transcribed. Analyses were completed with Novoic’s speech analysis software, using four key approaches: (1) feature extraction, (2) representations from large language models (LLM), (3) text‐similarity evaluation, and (4) autoscoring. Together, these evaluated audio, linguistic, and temporal speech domains. Outputs were entered into logistic regression models predicting Mild Cognitive Impairment (MCI)/mild AD and Amyloid positivity in MCI/mild AD. Area under the ROC curves (AUC) were evaluated via 5‐fold cross‐validation.Result165 older adults (including N = 74 MCI and 9 mild AD; of which N = 38 MCI/mild AD and amyloid beta positive) provided data for all tasks. Strength of model predictions varied by task, analytic approach and domain (Fig 1). AUCs predicting MCI/mild AD were generally higher for ASRTs compared to other tasks (Fig 1A). Text‐similarity approaches (G‐match: similarity of word embeddings between the source text and retelling, and V‐match: string‐based matching), produced the highest AUC for ASRTs (G‐match AUC = 0.87‐0.88), and the LMT (V‐match AUC = 0.83‐85). Autoscoring tasks produced the strongest predictor for the semantic fluency (AUC = 0.85), and also one of the strongest for phonemic fluency (AUC = 0.72). Changes in linguistic and temporal characteristics were more sensitive to MCI/mild AD, compared to audio‐only metrics. Amyloid in MCI/mild AD predictions were overall less strong (Fig 1B), with the most consistent pattern being better performance of text‐similarity approaches on story recall tasks (up to AUC = 0.77 for ASRTs, 0.73 for LMT).ConclusionSelection of task and analytic approach is important for developing more sensitive speech‐based testing. The best performing tasks (ASRT, Semantic Fluency) and metrics (text‐similarity metrics and autoscoring) have been incorporated in Novoic’s Storyteller automated remote speech‐based test.

Optimising speech‐testing to predict prodromal Alzheimer’s disease: head‐to‐head comparison study of tasks and analysis methods

AbstractBackgroundChanges in speech occur in early‐stage Alzheimer’s disease. A range of approaches have been used for eliciting and automatically analysing speech, but limited research has directly compared these methods.MethodParticipants from the AMYPRED‐UK (NCT04828122) and AMYPRED‐US (NCT04928976) studies completed four speech‐elicitation tasks: the Automatic Story Recall Task (ASRT), the Logical Memory Test (LMT), Semantic (Animals, Vegetables, Fruit) and Phonemic Verbal Fluency (F, A, S) Tasks. Responses were recorded and automatically transcribed. Analyses were completed with Novoic’s speech analysis software, using four key approaches: (1) feature extraction, (2) representations from large language models (LLM), (3) text‐similarity evaluation, and (4) autoscoring. Together, these evaluated audio, linguistic, and temporal speech domains. Outputs were entered into logistic regression models predicting Mild Cognitive Impairment (MCI)/mild AD and Amyloid positivity in MCI/mild AD. Area under the ROC curves (AUC) were evaluated via 5‐fold cross‐validation.Result165 older adults (including N = 74 MCI and 9 mild AD; of which N = 38 MCI/mild AD and amyloid beta positive) provided data for all tasks. Strength of model predictions varied by task, analytic approach and domain (Fig 1). AUCs predicting MCI/mild AD were generally higher for ASRTs compared to other tasks (Fig 1A). Text‐similarity approaches (G‐match: similarity of word embeddings between the source text and retelling, and V‐match: string‐based matching), produced the highest AUC for ASRTs (G‐match AUC = 0.87‐0.88), and the LMT (V‐match AUC = 0.83‐85). Autoscoring tasks produced the strongest predictor for the semantic fluency (AUC = 0.85), and also one of the strongest for phonemic fluency (AUC = 0.72). Changes in linguistic and temporal characteristics were more sensitive to MCI/mild AD, compared to audio‐only metrics. Amyloid in MCI/mild AD predictions were overall less strong (Fig 1B), with the most consistent pattern being better performance of text‐similarity approaches on story recall tasks (up to AUC = 0.77 for ASRTs, 0.73 for LMT).ConclusionSelection of task and analytic approach is important for developing more sensitive speech‐based testing. The best performing tasks (ASRT, Semantic Fluency) and metrics (text‐similarity metrics and autoscoring) have been incorporated in Novoic’s Storyteller automated remote speech‐based test.

On the retrieval of earliest memories

ABSTRACT Earliest memories were examined with respect to recollection type (i.e., remember-know), retrieval type (i.e., direct-generative), retrieval speed, and memory fluency (i.e., phonemic, semantic, and autobiographical). A total of 137 young adults (94 females; Mage = 20.47, SDage = 1.57) reported their earliest memories and specified their recollection and retrieval types for reported memories. They further dated their recollections by reporting the age at event, rated event characteristics and completed the phonemic, semantic, and autobiographical memory fluency tasks. Remembered and known earliest memories were similar in retrieval speed, but remembered memories were more prevalent. For retrieval type, direct and generative retrieval were similar in prevalence, but direct retrieval was faster in recalling the earliest memories. Directly retrieved memories were dated earlier than generated ones, but no such pattern in dating was observed for remember-know distinction. In terms of memory fluency, none of the three fluency tasks predicted the retrieval speed, recollection and retrieval type. For event characteristics, significant differences were observed only for vividness and rehearsal for both retrieval and recollection type. The present study is the first to explore recollection and retrieval type, retrieval speed, memory fluency together with dating and event characteristics in the context of earliest memories.