Semantic Fluency Test Research Articles

Determining associations between Big Five personality traits and executive function in an undergraduate student sample.

The present study sought to determine the associations between executive functioning and Big Five personality traits in an undergraduate sample. Participants included 200 undergraduates (73% women), with a mean age of approximately 21 years. Participants completed the Big Five Inventory-44 and a psychological assessment battery, which included the Trail Making Test and the Semantic Fluency Test. Results from multiple regression analyses suggested agreeableness was negatively associated with Semantic Fluency - Animals (β = -0.310, p < 0.001). Moreover, conscientiousness was positively associated with Trail Making Test B-A (β = 0.197, p = 0.016), but negatively associated with Trail Making Test A (β = -0.193, p = 0.017). Overall results identified that executive function association with personality varies by construct. Given conscientiousness' differential associations within the executive function task performances, future research should examine the conscientious threshold that would result in psychological symptomatology associated with extreme lows and highs in conscientiousness.

Different Markers of Semantic-Lexical Impairment Allow One to Obtain Different Information on the Conversion from MCI to AD: A Narrative Review of an Ongoing Research Program.

Background: In this narrative review, we have surveyed results obtained from a research program dealing with the role of semantic memory disorders as a predictor of progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD). Objectives: In this research program, we have taken into account many different putative markers, provided of a different complexity in the study of the semantic network. These markers ranged from the number of words produced on a semantic fluency task to the following: (a) the discrepancy between scores obtained on semantic vs. phonemic word fluency tests; (b) the presence, at the single-word level, of features (such as a loss of low typical words on a category verbal fluency task) typical of a degraded semantic system; or (c) the presence of more complex phenomena (such as the semantic distance between consecutively produced word pairs) concerning the organization of the semantic network. In the present review, all these studies have been presented, providing separate subsections for (a) methods, (b) results, and (c) a short discussion. Some tentative general conclusions have been drawn at the end of the review. We found that at baseline all these markers are impaired in MCI patients who will later convert to AD, but also that they do not necessarily show a linear worsening during the progression to AD and allow one to make different predictions about the time of development of AD. Our conclusions were that, rather than searching for the best marker of conversion, we should use a range of different markers allowing us to obtain the information most appropriate to the goal of our investigation.

Subthalamic nucleus deep brain stimulation modulates speech graphs in patients with Parkinson’s disease

Graph theory enables a direct quantification of topological properties of any arbitrary network. Its application in neuroscience has unveiled topological changes of brain networks associated with various neurodegenerative diseases. This study used the graph theory to understand speech deficits in patients with Parkinson’s disease (PD). In particular, this study investigated the effect of subthalamic nucleus deep brain stimulation (STN-DBS) on the topology of speech graphs. Sixty patients with PD completed a standard semantic fluency test with DBS switched ON and OFF. A control group of sixty matched nonsurgical PD patients completed the test once. All verbal responses were recorded, transcripted, and transformed into directed speech graphs. Volumes of tissue activated (VTA) were estimated for three STN subregions, including sensorimotor, associative, and limbic parts. First, the patients with DBS OFF produced smaller and denser speech graphs than nonsurgical patients, showing fewer nodes, higher density, shorter diameter, and shorter average shortest path. Second, DBS partially reversed the effect of surgery, leading to larger and sparser speech graphs with more nodes, lower density, longer diameter, and longer average shortest path (ON versus OFF). Third, however, the left associative VTA negatively correlated with the DBS-induced diameter and average shortest path changes (ON versus OFF), suggesting that the patients with greater left associative STN stimulation tended to produce smaller and denser speech graphs. This study demonstrates that STN-DBS can partially restore the topological structure of speech graphs in PD patients. However, stimulating the left associative STN appears to disrupt speech graphs.

Blood pressure, brain lesions and cognitive decline in patients with atrial fibrillation.

The influence of atrial fibrillation (AF) and blood pressure (BP) on brain lesions and cognitive function is unclear. We aimed to investigate the association of BP with different types of brain lesions and cognitive decline in patients with AF. Overall, 1,213 AF patients underwent standardized brain magnetic resonance imaging at baseline and after 2 years, as well as yearly neurocognitive testing. BP was measured at baseline and categorized according to guidelines. New lesions were defined as new or enlarged brain lesions after 2 years. We defined cognitive decline using three different neurocognitive tests. Logistic and Cox regression analyses were performed to examine the associations of BP with new brain lesions and cognitive decline. The mean age was 71 ± 8.4 years, 74% were male and mean BP was 135 ± 18/79 ± 12 mmHg. New ischemic lesions and white matter lesions were found in 5.4% and 18.4%, respectively. After multivariable adjustment, BP was not associated with the presence of new brain lesions after 2 years. There was no association between BP and cognitive decline over a median follow-up of 6 years when using the Montreal Cognitive Assessment or Digit Symbol Substitution Test. However, BP categories were inversely associated with cognitive decline using the Semantic Fluency Test, with the strongest association in patients with hypertension grade 1 [Hazard Ratio (95% Confidence Interval) 0.57(0.42 to 0.77)], compared to patients with optimal BP (p for linear trend: 0.025). In a large cohort of AF patients, there was no association between BP and incidence of brain lesions after 2 years. Also, there was no consistent association between BP and cognitive decline over a follow-up of 6 years. https://clinicaltrials.gov/study/NCT02105844, Identifier (NCT02105844).

Architecture and anatomy of executive processes: evidence from verbal fluency and Trail Making Test in 2009 stroke patients.

The few voxel-wise lesion-symptom mapping (VLSM) studies aimed at identifying the anatomy of executive function are limited by the absence of a model and by small populations. Using Trail Making Test (TMT) and verbal fluency and a model of their architectures, our objective was to identify the key structures underlying two major executive processes, set-shifting and strategic word search. We applied a validated VLSM analysis to harmonized cognitive and imaging data from 2009 ischemic stroke patients as a part of the Meta VCI Map consortium. All contrast analyses used an adjusted threshold with 2000 Freedman-Lane permutations (p ≤ 0.05). The TMT parts A and B were associated with structures involved in visual-spatial processing, the motor system, the frontal lobes, and their subcortical connections. Set-shifting depended on the left dorsomedial frontal region. Both semantic and phonemic fluency tests depended on verbal output abilities and processing speed with similar slopes in different languages. The strategic search process depended on Broca's area, F2 and related tracts, temporal and deep regions. Lastly, the lesion map of set-shifting did not overlap with those of strategic word search processes. Our results identify the anatomical substrates of two main executive processes, revealing that they represent only a specific subpart of previously reported structures. Finally, our results indicate that executive functions depend on several specific, anatomically separable executive processes mainly operating in various parts of the frontal lobes.

Can volumetric magnetic resonance imaging evaluations be helpful in the follow-up of cognitive functions in cognitively normal Parkinson's disease patients?

In this study, besides the evaluation of gray and white matter changes in cognitively normal Parkinson's disease (PD-CN) patients with volumetric magnetic resonance imaging (MRI) parameters, it was tried to show that some neuropsychological tests may be impaired in PD-CN patients. Twenty-six PD-CN patients and 26 healthy elderly (HC) participants were included in the current study. Global cognitive status was assessed using the mini-mental state examination (MMSE), and the Montreal cognitive assessment scale (MoCA). Attention and executive functions were evaluated using the Wechsler memory scale-revised (WMS-R) digit span test and trail making test (TMT) part A and part B, the Stroop test, semantic and phonemic fluency tests, and clock drawing test. Magnetic resonance imaging (MRI) was acquired according to the Alzheimer's disease neuroimaging initiative (ADNI) protocol. There were no significant differences among groups regarding age, sex, handedness, and years of education. In the comparison of the PD-CN group and the HC group, there was a statistical decrease in the total animal scores, lexical fluency, TMT part A and TMT part B scores in the PD-CN group. Subcortical gray matter volumes (GMV) were significantly lower in PD-CN patients. The PD-CN group had a significantly reduced total volume of right putamen and left angular gyrus compared to that in the HC group. We observed that putamen and angular gyrus volumes were lower in PD-CN patients. On the other hand, TMT part B may be a useful pretest in detecting the conversion of mild cognitive impairment in PD. Significant MRI volumetric measurements and neuropsychological test batteries can be helpful in the clinical follow-up in PD-CN patients.

Normative Data for the Famous People Fluency Test in the Adult French-Quebec Population and Validation Study in Mild Cognitive Impairment and Alzheimer's Disease.

The production of words in verbal fluency tests relies heavily on executive functions and linguistic abilities. New tests such as the famous people fluency test can also be useful in clinical practice and research. This test, in which participants are asked to name so many famous people, has the potential to distinguish healthy individuals from participants with neurological disorders such as mild cognitive impairment or Alzheimer's disease. The aim of this study was to determine the psychometric validity of the test (Study 1) and to provide normative data in the adult population of French Quebec for the famous people fluency test (Study 2). The results of the normative study, derived from a sample of 378 healthy individuals between the ages of 50 and 92, showed that age and educational level significantly influence performance on the test. Therefore, percentile ranks were calculated for performance on the famous people fluency test, stratified for these two variables. The results of Study 2 showed that the test differentiated the performance of healthy participants from the performance of participants with mild cognitive impairment or Alzheimer's disease. The results also showed that the famous people fluency test has adequate convergent validity, established with a semantic fluency test, and that the results showed good stability over time (test-retest validity). Norms and psychometric data for the famous people fluency test will improve the ability of clinicians and researchers to better recognize executive and language impairments associated with pathological conditions.

Using semantic verbal fluency to estimate the relative and absolute vocabulary size of bilinguals: An exploratory study of children and adolescents

IntroductionThe full assessment of bilingual children often involves at least one language for which formal vocabulary tests are lacking and which the examiner does not speak. We examined, in a sample of children with typical development (TD), whether a semantic verbal fluency task, typically used in research as a measure of executive function, could be used in the place of a formal vocabulary test to estimate vocabulary knowledge when formal tests are not available. Method113 TD monolingual French speakers and TD bilinguals and with varying degrees of exposure to French, age 6 to 17 years, completed tests of vocabulary knowledge and semantic verbal fluency. A subset of 64 participants spoke French and English and were tested in both languages. Verbal fluency measures calculated using a traditional method which uses specific rules for superordinate categories and for animals of different sex and age and a simplified scoring method which simply counts all words produced, included the total number of words produced in each language, Total Vocabulary and Conceptual Vocabulary measures combining both languages, as well as analyses of lexical composition and word frequency within the study sample. ResultsLinear regressions revealed that the number of words produced predicted vocabulary size in a language-specific way, with slightly stronger predictions made by the simplified scoring method. As expected, bilinguals produced more words and more unique words in their language of greater exposure, while different exposure groups were equivalent in measures combining both languages, including their Total vocabulary and Conceptual vocabulary. Producing unusual words (infrequently produced in the study sample) indicated higher vocabulary scores. ConclusionsThis study supports the use of the verbal fluency task as a quick and simple tool to obtain a rough estimate of vocabulary size in TD monolinguals and bilinguals. This tool shows promise as well in clinical work with other populations, subject to further verification.

Levodopa modulates semantic fluency and uniqueness in non-demented patients with progressive supranuclear palsy.

Semantic fluency is the ability to name items from a given category within a limited time, which relies on semantic knowledge, working memory, and executive function. Similar to patients with Parkinson's disease (PD), patients with progressive supranuclear palsy (PSP) scored lower than healthy adults in the well-established semantic fluency test. However, it is unclear how unique are the produced words. This study examined the relationship between semantic fluency and words' uniqueness in patients with PSP. Twenty-seven patients with PSP Richardson's syndrome (PSP-RS), 37 patients with PD, and 41 healthy controls (HC) performed a standard semantic fluency test (animals), and their verbal responses were audio-recorded. We used the uniqueness to reflect the ability to produce both original and effective work, that is, creativity. The PSP-RS group produced fewer correct words and fewer unique words than the PD and HC groups. Moreover, the correlation between fluency and uniqueness was positive in the HC and PD groups but negative in the PSP-RS group. Importantly, the actual levodopa dose was positively correlated with the fluency but negatively correlated with the uniqueness in PSP-RS. The PSP-RS patients who took a greater dose of levodopa tended to produce more correct words but fewer unique words. These results suggested that levodopa may modulate semantic fluency and uniqueness in the early stages of PSP-RS.

Assessment tools for cognitive performance in Parkinson's disease and its genetic contributors.

We have shown that genetic factors associating with motor progression of Parkinson's disease (PD), but their roles in cognitive function is poorly understood. One reason is that while cognitive performance in PD can be evaluated by various cognitive scales, there is no definitive guide indicating which tool performs better. Data were obtained from the Parkinson's Progression Markers Initiative, where cognitive performance was assessed using five cognitive screening tools, including Symbol Digit Modalities Test (SDMT), Montreal Cognitive Assessment, Benton Judgment of Line Orientation, Modified Semantic Fluency Test, and Letter Number Sequencing Test, at baseline and subsequent annual follow-up visit for 5 years. Genetic data including ApoE and other PD risk genetic information were also obtained. We used SPSS-receiver operating characteristic and ANOVA repeated measures to evaluate which cognitive assessment is the best reflecting cognitive performance in PD at early stage and over time. Logistic regression analyses were used to determine the genetic associations with the rapidity of cognitive decline in PD. SDMT performed better in detecting mild cognitive impairment at baseline (AUC = 0.763), and SDMT was the only tool showing a steady cognitive decline during longitudinal observation. Multigenetic factors significantly associated with cognitive impairment at early stage of the disease (AUC = 0.950) with IP6K2 rs12497850 more evident, and a significantly faster decline (AUC = 0.831) within 5 years after motor onset, particularly in those carrying FGF20 rs591323. SDMT is a preferable cognitive assessment tool for PD and genetic factors synergistically contribute to the cognitive dysfunction in PD.

Enhanced Learning and Memory in Patients with CRB1 Retinopathy.

Neuropsychological tests of cognitive function were used to test individuals with CRB1 and non-CRB1 retinopathies and compare results with a standardised normative dataset. CRB1 retinopathy subjects significantly outperformed those with non-CRB1 retinopathy in list learning tasks of immediate (p = 0.001) and delayed memory (p = 0.007), tests of semantic verbal fluency (p = 0.017), verbal IQ digit span subtest (p = 0.037), and estimation test of higher execution function (p = 0.020) but not in the remaining tests of cognitive function (p > 0.05). CRB1 retinopathy subjects scored significantly higher than the normal population in all areas of memory testing (p < 0.05) and overall verbal IQ tests (p = 0.0012). Non-CRB1 retinopathy subjects scored significantly higher than the normal population in story recall, verbal fluency, and overall verbal IQ tests (p = 0.0016). Subjects with CRB1 retinopathy may have enhanced cognitive function in areas of memory and learning. Further work is required to understand the role of CRB1 in cognition.

Predicting clinical progression and cognitive decline in patients with relapsing-remitting multiple sclerosis: a 6-year follow-up study.

Cognitive impairment occurs from the earliest stages of multiple sclerosis (MS) and progresses over time. The introduction of disease modifying therapies (DMTs) has changed the prognosis for MS patients, offering a potential opportunity for improvement in the cognitive arena as well. 41 patients with relapsing-remitting multiple sclerosis (MS) were recruited to the study. Thirty patients were available for final follow-up and were included in the analysis. Baseline (BL) brain MRI including volumetry and neuropsychological tests were performed. Blood samples were collected at BL and follow-up (FU) and were tested for: vascular endothelial growth factor (VEGF), soluble vascular cell adhesion molecule-1 (sVCAM1), soluble platelet-endothelial CAM-1 (sPECAM1), and soluble intercellular CAM-1 (sICAM-1). Patients were invited for a final neuropsychological follow-up after a median of 6 years. Disease activity (relapses, EDSS increase, new/active brain lesions on MRI) was analysed between BL and FU. The study group deteriorated in the Rey-Osterrieth Complex Figure (ROCF) test (p = 0.001), but improved significantly in three other tests, i.e. semantic fluency test (p = 0.013), California Verbal Learning Test (CVLT, p = 0.016), and Word Comprehension Test (WCT, p < 0.001). EDSS increase correlated negatively with semantic fluency and WCT scores (r = -0.579, p = 0.001 and r = -0.391, p = 0.033, respectively). Improvements in semantic fluency test and WCT correlated positively with baseline deep grey matter, grey matter, and cortical volumes (p < 0.05, r > 0). Higher EDSS on FU correlated significantly negatively with baseline left and right pallidum, right caudate, right putamen, right accumbens, and cortical volume (p < 0.05, r < 0). No significant relationship was found between the number of relapses and EDSS on FU or neuropsychological deteriorations. Improvements in WCT and CVLT correlated positively with baseline sPECAM1 and sVCAM1 results, respectively (r > 0, p < 0.05). Deterioration in ROCF test correlated significantly with higher levels of baseline VEGF and sVCAM1 (p < 0.05). Brain volume is an important predictor of future EDSS and cognitive functions outcome. MS patients have a potential for improving in neuropsychological tests over time. It remains to be established whether this is related to successful disease modification with immunotherapy. Baseline volumetric measures are stronger predictors of cognitive performance than relapse activity, which yet again highlights the importance of atrophy in MS prognosis.

Predictors of self-reported word-finding difficulties in glioma patients – a longitudinal study

ABSTRACT Background Word-finding difficulties are a common self-reported concern in glioma patients known to negatively affect social participation and life satisfaction. Discrepancies between self-reported difficulties and performance on objective tests have been reported, but studies are seldom conducted longitudinally. Aims The aim of the present study was to examine the occurrence of self-reported word-finding difficulties before and during the first year after glioma surgery. In addition, we investigated whether self-reported word-finding difficulties were predicted by standardized language tests and psychological distress. Methods and procedures Twenty-three patients with gliomas (grade 1–3) were assessed pre-surgery, at six and twelve months follow-up. Self-reported word-finding difficulties were addressed with the item I am able to find the right word(s) to say what I mean, from the Functional Assessment of Cancer Therapy – Brain (FACT-Br). Confrontation naming was tested with the Boston Naming Test (BNT), word production with a semantic fluency test and word knowledge with a vocabulary test. Self-reported measures of psychological distress were assessed with the Hospital Anxiety and Depression Scale (HADS). Ordinal regression models were used to examine predictors of self-reported word-finding difficulties. Outcomes and results Word-finding difficulties were reported by 68% of the patients pre-surgery, increasing to 90% and 85% at the following assessments. Significant changes were observed in the magnitude of reported concerns between pre-surgery assessment and six months follow-up. Regression analyses demonstated that self-reported word-finding difficulties were predicted by psychological distress and vocabulary pre-surgery and vocabulary at six months follow-up, whereas confrontation naming and semantic fluency did not become significant in any of the assessments. Conclusion Our results indicate that self-reported word-finding difficulties occurred in a high percentage of glioma patients throughout the first year of illness. Patients reported increased difficulties after surgery that were not predicted by confrontation naming or semantic fluency but by vocabulary performance. The results imply further that psychological distress is a factor that should be taken into account. Self-reported function is an important supplement to objective testing and can provide indications about mental health status and the patients` perspective on language related challenges in everyday life.

Lymphocyte level and selected cognitive functions in patients with schizophrenia – preliminary results

IntroductionSchizophrenia is a mental disorder characterized by negative symptoms, such as cognitive impairment. Recent reports indicate the importance of the immune system in the pathophysiology of schizophrenia. The development of inflammation affects cognitive functioning.ObjectivesThe aim of the study was to analyze the association between the level of lymphocytes in venous blood and selected cognitive functions in patients with schizophrenia.MethodsLymphocyte levels were determined in the venous blood of patients suffering from schizophrenia and the control group. Additionally, a verbal fluency test (VFT) and a Stroop test were conducted on the same day. The VFT evaluates the ability to express words, and the Stroop test assesses verbal working memory. The inclusion criteria were age up to fifty years, and for the study group – diagnosis of schizophrenia and treatment with neuroleptics. Exclusion criteria included organic brain diseases, electroconvulsive therapy, and use of benzodiazepines within 48 hours before the study. Currently, six patients and six healthy people have been studied.Results Patients diagnosed with schizophrenia have an increased lymphocyte concentration in the blood compared to healthy individuals constituting the control group. There are discrepancies in the results of the phonemic fluency test, no significant differences were found between schizophrenics and the control group. Healthy men and women achieved higher results in the semantic fluency test compared to men and women with schizophrenia. Women constituting the control group achieved higher results in the Stroop test compared to women suffering from schizophrenia. Table 1 illustrates the concentration of lymphocytes in venous blood and the number of points in the phonemic fluency test, semantic fluency test, and in the Stroop test of the study and the control groups.Image:Conclusions Patients with schizophrenia are characterized by higher levels of immune system parameters and worse results in terms of semantic fluency. Men with schizophrenia showed no verbal working memory deficits. In turn, women with schizophrenia obtained worse results in the verbal working memory test. In conclusion, there is evidence of immune system activation in schizophrenia, which affects the cognitive functioning of patients.Disclosure of InterestNone Declared

Polypharmacy, drug-drug interactions, anticholinergic burden and cognitive outcomes: a snapshot from a community-dwelling sample of older men and women in northern Italy

Polypharmacy (PP) use is very common in older people and may lead to drug-drug interactions (DDIs) and anticholinergic burden (ACB) that may affect cognitive function. We aimed to determine the occurrence of PP, potential DDIs and ACB and their role in cognitive outcomes in an older population. Cross-sectional data from 636 community-dwelling adults (73.2 ± 6.0 SD, 58.6% women) participating in the NutBrain study (2019–2023) were analyzed. Participants were asked about their medication use, and data on potential DDIs and ACB were extracted. The associations of PP (≥ 5 drugs/day), potential DDIs, and ACB with mild cognitive impairment (MCI) and specific cognitive domains were assessed using logistic regression adjusted for confounders. Sex-stratified analysis was performed. Overall, 27.2% of the participants were exposed to PP, 42.3% to potential DDIs and 19% to cumulative ACB. Women were less exposed to PP and more exposed to ACB than men. In multivariate analysis, the odds of having MCI (24%) were three times higher in those with severe ACB (≥ 3) (OR 3.34, 95%CI 1.35–8.25). ACB was positively associated with poor executive function (OR 4.45, 95%CI 1.72–11.49) and specifically with the Frontal Assessment Battery and neuropsychological tests of phonological and semantic fluency. In sex-stratified analysis, ACB was statistically significantly associated with MCI and executive function in women and with memory in men. PP, potential DDIs and anticholinergics use are very common in community-dwelling older people. ACB exposure is associated with MCI, particularly with poor executive function. Clinicians are encouraged to be vigilant when prescribing anticholinergics.Trial registration: Trial registration number NCT04461951, date of registration July 7, 2020 (retrospectively registered, ClinicalTrials.gov).

Corpus callosum and cerebellum participate in semantic dysfunction of Parkinson's disease: a diffusion tensor imaging-based cross-sectional study.

Language dysfunction is common in Parkinson's disease (PD) patients, among which, the decline of semantic fluency is usually observed. This study aims to explore the relationship between white matter (WM) alterations and semantic fluency changes in PD patients. 127 PD patients from the Parkinson's Progression Markers Initiative cohort who received diffusion tensor imaging scanning, clinical assessment and semantic fluency test (SFT) were included. Tract-based special statistics, automated fiber quantification, graph-theoretical and network-based analyses were performed to analyze the correlation between WM structural changes, brain network features and semantic fluency in PD patients. Fractional anisotropy of corpus callosum, anterior thalamic radiation, inferior front-occipital fasciculus, and uncinate fasciculus, were positively correlated with SFT scores, while a negative correlation was identified between radial diffusion of the corpus callosum, inferior longitudinal fasciculus, and SFT scores. Automatic fiber quantification identified similar alterations with more details in these WM tracts. Brain network analysis positively correlated SFT scores with nodal efficiency of cerebellar lobule VIII, and nodal local efficiency of cerebellar lobule X. WM integrity and myelin integrity in the corpus callosum and several other language-related WM tracts may influence the semantic function in PD patients. Damage to the cerebellum lobule VIII and lobule X may also be involved in semantic dysfunction in PD patients.

Association between Depressive Mood, Antidepressant Therapy and Neuropsychological Performances: Results from a Cross-Sectional Study on Elderly Patients.

Currently, the global demographic landscape is undergoing a transformative shift towards an increasingly aging population. This leads to an increase in chronic pathologies, including depression and cognitive impairment. This study aimed to evaluate the association between depressive mood, whether in treatment or not, and cognitive capacities, assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). This study included 259 subjects, aged 65 years or older, evaluated at the Geriatric Outpatient Service of the University Hospital of Monserrato, Cagliari, between July 2018 and May 2022, who experienced subjective depressive mood and/or cognitive deficits. Only 25.1% of the sample showed no cognitive impairment on the RBANS. Education was a significant regressor of the RBANS Total Scale scores (p < 0.0001) and was negatively associated with mood deflection (r = -0.15, p = 0.0161). Subjects with depressive mood had more impaired attention and visuospatial/constructional abilities compared to untreated euthymic patients. Post-hoc analysis, conducted with the Conover test, showed that untreated euthymic patients (GDS-15 ≤ 5, group 2) had a higher score on the RBANS total scale than patients with mood deflection (GDS-15 > 5, group 1), and treated euthymic patients (GDS-15 ≤ 5, group 3). Finally, different logistic regression analyses revealed a significant negative coefficient for GDS as a regressor of the RBANS total scale (coefficient: -0.04, p = 0.0089), visuospatial/constructional abilities (coefficient: -0.03, p = 0.0009), language (coefficient: -0.05, p = 0.0140), and attention (coefficient: -0.05, p < 0.0001). Our analysis demonstrated that "naturally" euthymic people show better cognitive performances than people with depressive mood and subjects with acceptable mood due to antidepressants. Furthermore, the gender-based difference observed in the language domain suggests the potential utility of incorporating an alternative category for male patients in the Semantic Fluency test.

Translation and Psychometric Properties of the Portuguese Version of the Timed Instrumental Activities of Daily Living (TIADL).

(1) Background: to examine the psychometric properties of the Portuguese version of the Timed Instrumental Activities of Daily Living (TIADL) in nursing home residents. (2) Methods: Fifty-two participants (85.8 ± 4.2 years) were assessed on two occasions, 10-14 days apart. The same rater administered all assessments. Internal consistency was analysed through Cronbach's α. The reliability was estimated using the intraclass correlation coefficients (ICCs), and the standard error of the mean (SEM) was used to estimate the minimal detectable change (MDC). Construct validity was determined by Spearman's correlation coefficients. (3) Results: For internal consistency, Cronbach's α (0.81) revealed high internal reliability. All of the subtests demonstrated good or excellent reliability and also presented acceptable measurement precision, considering the criterion SEM < SD/2. According to Spearman's rho, correlations with the Portuguese version of the TIADL, the Useful Field of View test, and semantic and phonemic fluency tests were significant, with moderate positive and negative correlations (0.4 < rs < 0.69). (4) Conclusions: The Portuguese version of the TIADL had good to excellent test-retest reliability (ICC > 0.90) and acceptable measurement precision. This test could be a valuable clinical tool for assessing actual performance in instrumental activities of daily living in nursing home residents.

Semantic cognition as an early cognitive marker of Alzheimer’s disease: importance of executive processes mediation

AbstractBackgroundImpaired semantic memory is one of the earliest characteristic features of Alzheimer’s disease. Its assessment is crucial to accurately predict conversion to Alzheimer disease related disorders (ADRD). Recent evidence supports the necessity to differentiate between subprocesses of semantic cognition: a) activation in the semantic representation system; b) executive processes to control or select relevant aspects of semantic knowledge. In this study we compare semantic memory tests that differ in these subprocesses to find out which of them are the best predictors of conversion of MCI to ACD in two years. We also want to identify which semantic memory tests have more sensitivity and specificity at the baseline in the differentiation MCI‐no converters and MCI converters after two yearsMethodWe assessed 130 amnestic MCI patients. Semantic memory tests more based on integrity of semantic knowledge (Similarities, ACE‐language) and more executive determined (verbal fluency – phonemic and categories, Boston Naming Test) were administered at baseline and at 2‐years follow‐up, together with cognitive screening tools and IADL measures. A binary regression model was used to examine which semantic memory tests predict MCI progression to Alzheimer’s Clinical Syndrome (ACS) in two years. ROC curves were used to study early clinical diagnosis differentiating MCI converters and MCI non convertersResultOnly semantic category fluency test significantly explained the conversion to ACS (p&lt;.01). Baseline score semantic categories fluency were significantly lower in MCI patients who develop ACS after two years (p&lt;.001). ROC curves showed that semantic categories fluency and Boston Naming tests were the best tests to differentiate at baseline between MCI converter and non‐converter (AUC = 0.768, p&lt;0,0001 and AUC = 0.712, p&lt;0,01, respectively)ConclusionSemantic category fluency test was the best predictor from MCI to ACS conversion in two years. Semantic category fluency and Boston Naming tests clearly identify people with high risk to develop ACS in two years. Semantic memory tests including executive contributions could detect and characterize prodromal Alzheimer’s disease

Plasma biomarkers as prognostic markers in Alzheimer’s disease: Influence of age at onset

AbstractBackgroundLittle is known about the influence of age at onset (AAO) on plasma biomarkers and their use as prognostic biomarkers in Alzheimer’s disease (AD).MethodWe selected patients with AD diagnosis with available neuropsychological testing (NPS) at time of diagnosis and two years later, and plasma biomarkers at baseline.NPS battery included Free and Cued Selective Reminding Test (FCSRT), Landscape test (visual memory), Boston Naming Test, Semantic Fluency, BDAE auditory comprehension, Constructional and Ideomotor Praxis, Visual Object and Space Perception (VOSP) Incomplete Letters and Number Location subtests, Trail Making Test (TMT) A and B, Phonemic Fluency, and Digit Span Forward and Backward. NPS scores were compared by AAO: early‐onset AD (EOAD; &lt;65 years) vs. late onset AD (LOAD; &gt;65y).We analyzed plasma biomarkers phosphorilated‐tau181 (p‐tau181), total tau (t‐tau), neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP) and ubiquitin C‐terminal hydrolase L1 (UCHL‐1) using the Quanterix Simoa p‐tau181 Advantage V2 and Neurology 4‐Plex A assays. Group comparisons and linear regressions adjusted by years of education (YOE) were performed in Stata/IC 16.1.ResultForty‐two participants were included, 23 LOAD and 19 EOAD. Plasma p‐tau181 and GFAP levels were higher in LOAD (Table 1). We did not find differences between LOAD and EOAD in NPS tests at baseline or +2 years (Table 2).Plasma ptau‐181 was associated with progression in MMSE globally, VOSP‐Incomplete letters globally and in EOAD. Plasma NfL were associated to Boston Naming test globally and in EOAD, Semantic fluency test globally, VOSP‐incomplete letters in EOAD, and Free and Total Learning of FCSRT in LOAD. Plasma GFAP was associated to MMSE globally and in EOAD, Free learning of FCSRT in LOAD and VOSP‐Incomplete letters and number location globally. Plasma UCHL‐1 was associated to Semantic fluency test in LOAD (Table 3). Praxis and attention and executive function tests loss were not associated to plasma biomarkers.ConclusionPlasma p‐tau18, NfL, GFAP and UCHL‐1 were associated to pogression in memory, language and visual tests. They were predominantly associated to memory loss in LOAD and language and visual function loss in EOAD. Results need to be interpreted cautiously due to small sample size.