Word Fluency Test Research Articles

N–3 Fatty acids, hypertension and risk of cognitive decline among older adults in the Atherosclerosis Risk in Communities (ARIC) study

Recent research indicates that n-3 fatty acids can inhibit cognitive decline, perhaps differentially by hypertensive status. We tested these hypotheses in a prospective cohort study (the Atherosclerosis Risk in Communities). Dietary assessment using a food-frequency questionnaire and plasma fatty acid exposure by gas chromatography were completed in 1987-1989 (visit 1), while cognitive assessment with three screening tools--the Delayed Word Recall Test, the Digit Symbol Substitution Test of the Wechsler Adult Intelligence Scale-Revised and the Word Fluency Test (WFT)--was completed in 1990-1992 (visit 2) and 1996-1998 (visit 4). Regression calibration and simulation extrapolation were used to control for measurement error in dietary exposures. Four US communities--Forsyth County (North Carolina), Jackson (Mississippi), suburbs of Minneapolis (Minnesota) and Washington County (Maryland). Men and women aged 50-65 years at visit 1 with complete dietary data (n = 7814); white men and women in same age group in the Minnesota field centre with complete plasma fatty acid data (n = 2251). Findings indicated that an increase of one standard deviation in dietary long-chain n-3 fatty acids (% of energy intake) and balancing long-chain n-3/n-6 decreased the risk of 6-year cognitive decline in verbal fluency with an odds ratio (95% confidence interval) of 0.79 (0.66-0.95) and 0.81 (0.68-0.96), respectively, among hypertensives. An interaction with hypertensive status was found for dietary long-chain n-3 fatty acids (g day-1) and WFT decline (likelihood ratio test, P = 0.06). This exposure in plasma cholesteryl esters was also protective against WFT decline, particularly among hypertensives (OR = 0.51, P < 0.05). One implication from our study is that diets rich in fatty acids of marine origin should be considered for middle-aged hypertensive subjects. To this end, randomised clinical trials are needed.

Blood pressure is associated with cognitive impairment in young hypertensives

Aims: The present study was conducted to assess the effects of duration of hypertension, systolic hypertension, diastolic hypertension, drug compliance and class-of-drug on cognitive functions. Methods and results: A cohort of young hypertensive subjects was recruited after obtaining informed consent. Subjects with confounding factors, e.g., substance use, neurological disorders, endocrinopathies, inflammatory conditions, psychiatric illnesses, etc., were excluded. Their average systolic and diastolic blood pressure since onset of illness and prescribed drugs were noted from the records. Compliance was assessed with the help of information from subjects as well as the close relatives. MMSE and a battery of neuropsychological tests (Digit Span Test, Trail Making Test Form B, Stroop Test, Visuospatial Working Memory Matrix and Word Fluency Test) was applied to all the participants. Multivariate regression analysis was used for the assessment of associations and one-way ANOVA was performed to assess differences in the mean. Analysis showed that mean age of study subject was 52 years and average duration of hypertension was 9 years. Fourteen percent subjects had obvious cognitive impairment as suggested by MMSE score less than 23. However, when cut-off score was lowered to 20, only 6% subjects fell into this category. Diastolic blood pressure had significant negative association with all of the cognitive measures except Trail Making Test, which was, on the contrary, significantly and negatively associated with systolic blood pressure. Duration of hypertension did not influence cognitive performance in this study. Effect of drug compliance was somewhat variable, but in general good compliance was associated with better cognitive performance. β-Blocker therapy hampered cognitive performance, whereas the best performance, especially on tests of semantic memory and pre-frontal functions was seen in subjects taking calcium channel blockers. Conclusions: Diastolic hypertension was associated with significant impairment of cognitive functions in younger subjects. On the other hand good compliance and calcium channel blockers had protective effect on hypertension induced cognitive impairment, especially on the prefrontal functions.

Frontal cognitive dysfunction in juvenile myoclonic epilepsy

The aim of the present study was to investigate the possible frontal cognitive dysfunction in patients with juvenile myoclonic epilepsy (JME) and to compare the results with those of patients with frontal lobe epilepsy (FLE) and temporal lobe epilepsy (TLE), as well as with controls. A total of 50 patients with JME, 40 patients with FLE, 40 patients with TLE, and 40 normal controls, all matched for age, education, and IQ, were administered tests to assess frontal functions (the Word Fluency Test and the Wisconsin Card Sorting Test [WCST]). All participants had a normal intelligence level based on the Wechsler Adult Intelligence Scale, and did not take medications other than antiepileptics (AEDs) or have a psychiatric history. Patients with JME had severe impairment in all administered tasks, similar to that of patients with FLE; TLE patients and controls followed in order. Multiple regression analysis did not disclose any significant effect of clinical variables on the cognitive deficits. These results clearly suggest that JME patients can show some frontal dysfunction, which may affect both epileptogenic features and cognitive processes. Further studies are needed to confirm these findings.

Experimental evidence for a motivational origin of cognitive impairment in major depression

Diagnostic criteria and empirical evidence support the existence of cognitive deficits in depression. However, depressed mood, loss of interest and low self-efficacy might influence cognitive performance. Goal-setting instructions were used to promote motivation in depressed patients and control subjects during neuropsychological assessment. The resulting performance was compared with performance using standard instructions. Sixty in-patients with non-psychotic unipolar depression and 60 age- and education-matched healthy control subjects were assessed with standard neuropsychological tests [the Auditory Verbal Learning Test (AVLT), the Digit Symbol Test (DST), the Regensburg Word Fluency Test (RWT), and the Number Combination Test (Zahlen-Verbindungs-Test, ZVT)] using either goal-setting or standard test instructions. Depressed patients showed lower baseline performance and lower generalized self-efficacy (p<0.0005) than controls. However, goal-setting instructions significantly improved patients' memory performance by 10% [AVLT: F(5, 54)=3.611, p=0.007] and psychomotor performance by 13% [ZVT: F(3, 56)=3.667, p=0.017]. Consequently, patients and control subjects demonstrated similar results when goal-setting instructions were applied. Goal-setting instructions showed a statistical trend, increasing patients' performance in the DST by 12% [F(1, 58)=2.990, p=0.089], although their verbal fluency measured by the RWT did not increase. No significant correlations of increased performance with generalized self-efficacy were found. Cognitive deficits in depressed patients are influenced by motivational shortcomings. Because generalized self-efficacy failed to correlate to increased test performance, future research needs to disentangle the effective components of goal-setting instructions. Task-specific self-efficacy as well as enhancement of task-focused attention might underlie the significant goal-setting effect in depressed patients.

The relationship of intelligence to executive function and non-executive function measures in a sample of average, above average, and gifted youth

This study explores the relationship of intelligence to the Wisconsin Card Sorting Test, Stroop Color-Word Test, Oral Word Fluency Test, Design Fluency Test, Trail Making Test, contrasted with Rey Complex Figure Test, Rey Auditory Verbal Learning Test, Wide Range Achievement Test, and Underlining Test in average, above average and gifted children. Full-Scale IQ was significantly related to Wisconsin Card Sort Perseverative and Non-Perseverative Errors, Stroop Color-Word Test, Color-Word condition, Controlled Oral Word Fluency, Design Fluency, Rey Complex Figure, and Underlining conditions but not Trails or Rey Auditory Verbal Learning Test. MANCOVA's show gifted children outperformed other children on the executive but not the non-executive tests. Finally, the nature of the neuropsychological/IQ relationship was explored by further analyses.

The link between dyslexic traits, executive functioning, impulsivity and social self-esteem among an offender and non-offender sample

Purpose The current study had two core aims; first to explore the link between dyslexic traits and other aspects of functioning among a sample of offenders and non-offenders (students); and, second, to explore if dyslexic traits were over-represented among offenders. A subsidiary aim was to explore if the results were influenced by an offender's current index offence (i.e. violent versus non-violent). Method Ninety-two adult male participants took part: sixty offenders and thirty-two non-offenders. All completed a structured interview assessing dyslexic traits, namely the Dyslexia Adult Screening Test battery (DAST: Fawcett and Nicholson, 1998). Participants also completed a measure of executive functioning (Benton Word Fluency Test, Benton, A. (1968) Differential behavioural effects in frontal lobe disease. Neuropsychologica, 6, 53–60), impulsivity (Barratt Impulsiveness Scale: BIS-II, Barratt, E.S. (1994), Impulsiveness and Aggression. In J. Monahan and H.J. Steadman (Eds.), Violence and Mental Disorder: Developments in Risk Assessment (pp.61–79). Chicago: University of Chicago Press.) and social self-esteem (Texas Social Behavior Inventory: TSBI, Helmreich and Stapp, 1974). Results Offenders presented with more dyslexic traits than non-offenders, with those with violent index offences presenting with more traits than those with non-violent index offences. Offenders performed poorly on assessments of executive functioning when compared with non-offenders. Dyslexic traits were predicted most significantly by executive functioning difficulties followed by decreased social self-esteem. There was a trend for increased impulsivity to correlate with increased dyslexic traits. Dyslexic traits were also predictive of membership to the offender group whereas impulsivity, executive functioning or social self-esteem was not. Conclusion Preliminary evidence is provided for increased dyslexic traits among offenders compared to non-offenders. The study highlights the correlates of dyslexic traits. The implications of these findings for future research are outlined.

Changes in Everyday and Semantic Memory Function After Electroconvulsive Therapy for Unipolar Depression

This long-term prospective study focuses on the effects of electroconvulsive therapy (ECT) on everyday memory function and on semantic memory function. Results of memory test from 96 consecutive inpatients treated for unipolar depression were analyzed prospectively before ECT, after ECT treatment, and at 3- and 12-month follow-up. Everyday memory function was assessed by means of the Rivermead Behavioural Memory Test (RBMT) and semantic memory by 2 forms of the word fluency test. In our study, age had a constant and significant negative effect on everyday memory (RBMT score) over time. Bilateral electrode placement mainly influenced everyday memory, which was significantly improved at 3-month follow-up. One year after discharge, the RBMT scores were not significantly different from pretreatment levels, indicating that ECT does not affect everyday memory on the longer term. Scores on both word fluency tests for semantic memory were significantly influenced by age over time. The effect of age changed from a negative influence directly after ECT to a positive effect at follow-up. This advantage of higher age indicates that the semantic memory of older patients receiving ECT for severe mood disorder shows greater improvement at follow-up compared with younger patients. Over time, the scores on only 1 of the word fluency tests were significantly influenced by mainly bilateral electrode placement. A small but reversible decrease in everyday memory occurs after ECT in depressed patients, which is influenced by age and electrode placement. Semantic memory shows a fluctuating but recovering course, which is also influenced by age and electrode placement. During follow-up, the improvement in semantic memory was greater in the older patients.

Primary Progressive Aphasia: Relationship Between Gender and Severity of Language Impairment

Factors influencing the course and severity of symptoms in primary progressive aphasia (PPA), a language-based dementia, have not been fully elucidated. The current study examined the influence of gender on performance on tests of naming and verbal fluency in patients with PPA. Comparisons were also made within a group of probable Alzheimer disease (AD) patients to determine whether gender differences were present in the most common form of neurodegenerative dementia. Performance was compared by gender within each diagnostic group on 3 language measures: the Boston Naming Test, category fluency (animals), and lexical fluency (FAS). Scores were compared at baseline (Visit 1) and in a subset of participants 6 to 15 months later (Visit 2). Compared to men, women with PPA demonstrated significantly greater impairment on word fluency tests at both visits and also had a more aggressive rate of decline between visits. AD patients showed no differences by gender on any measure. The results suggest gender-based vulnerability in PPA where women express more severe language impairments than men given a similar duration of illness.

Plasma Carotenoid Levels and Cognitive Performance in an Elderly Population: Results of the EVA Study

The hypothesis of carotenoids having a preventive role in cognitive impairment is suggested by their antioxidant properties. We examined, in a cross-sectional analysis, the relationship between cognitive performance (assessed by the Mini-Mental State Examination, Trail Making Test Part B, Digit Symbol Substitution, Finger Tapping Test, and Word Fluency Test) and different plasma carotenoids (lutein, zeaxanthin, beta-cryptoxanthin, lycopene, alpha-carotene, and trans-beta-carotene and cis-beta-carotene) in a healthy elderly population (the EVA,"Etude du Vieillissement Artériel," study; n = 589, age = 73.5 +/- 3 years). Logistic regression showed that participants with the lowest cognitive functioning (<25th percentile) had a higher probability of having low levels of specific plasma carotenoids (<1st quartile): lycopene and zeaxanthin. For zeaxanthin, odds ratios (ORs) were as follows: OR(DSS) = 1.97 (95% confidence interval [CI] = 1.21-3.20), OR(FTT) = 1.70 (CI = 1.05-2.74), and OR(WFT) = 1.82 (CI = 1.08-3.07); for lycopene, OR(DSS) = 1.93 (CI = 1.20-3.12) and OR(TMTB) = 1.64 (CI = 1.04-2.59). Even if it is not possible to affirm if these low levels of carotenoids precede or are the consequence of cognitive impairment, our results suggest that low carotenoid levels could play a role in cognitive impairment. The biological significance of our findings needs further research.

Contribution of divergent thinking to community functioning in schizophrenia

Fluency deficits have been associated with poor community functioning in patients with schizophrenia. In our previous study we demonstrated that the ability to generate higher-quality responses on tasks of divergent thinking as measured by several fluency tests was impaired in patients with schizophrenia. The purpose of the present study was to investigate the contribution of the deficits in divergent thinking to community dysfunction in schizophrenia. Forty Japanese outpatients with schizophrenia and 32 healthy control subjects were recruited for this study and assessed over a broad spectrum of the neurocognitive domain. Their capacity for divergent thinking was assessed by idea, design, and word fluency tests. Community functioning was assessed by using the Global Assessment of Functioning (GAF), the Life Assessment Scale for the Mentally Ill (LASMI), and the Social Functioning Scale (SFS). The results confirmed the qualitative deficits of divergent thinking in schizophrenia. Stepwise multiple regressions using neurocognitive and demographic/clinical variables as predictors revealed that the higher-quality response scores on the tasks of divergent thinking significantly contributed to community functioning. Moreover, the deficit on the verbal task of divergent thinking significantly contributed to impairment in the area of daily living, and the deficit on the nonverbal task of divergent thinking significantly contributed to impairment in the area of interpersonal relations. The results of this study reveal the importance and the possibility of cognitive remediation and cognitive training with strategies that target capacity for divergent thinking to improve community functioning in patients with schizophrenia.

The Development of Naming and Word Fluency: Evidence From Hebrew-Speaking Children Between Ages 8 and 17

Naming and word fluency tests are commonly used in neuropsychological evaluations of both children and adults. The current work examines at which age performance on these tests reaches adult level. One hundred fifty children, 30 in each of 5 age groups (8–9, 10–11, 12–13, 14–15, 16–17), and 30 adults ages 18 to 29, participated in the study. Participants completed a Hebrew naming test, a three-letter phonemic fluency task, and a three-category semantic fluency task (animals, fruits and vegetables, and vehicles). Results show that all measures increase steadily from age 8 to age 17. No difference between the 16- to 17-year-old adolescents and the adults was found on the naming test and on the phonemic fluency task, but such a difference was documented for semantic fluency. The relative contribution of the maturation of vocabulary and the development of efficient retrieval processes to performance on naming and fluency tasks is discussed.

パーキンソン病における Stroop reaction time を用いた前頭葉機能の検討

The purpose of this study is to examine frontal lobe function of non-dementia Parkinson's disease (PD) patients. We examined the neuropsychological and behavioral evaluation (Stroop reaction time: SRT). Target image (20%) and non-target image (80%) were presented to PD patients, healthy elderly controls, and healthy young subjects at random. We instructed subjects that the button should pressed on the target image. This study was designed to investigate the mental set under three conditions. The Stroop test, Word Fluency Test (WFT), and Geriatric Depression Scale (GDS) were used to assess cognitive function. The SRT of PD were congruent condition and incongruent condition increased compared with simple condition. The delay of a similar SRT was seen in the healthy elderly control and young groups. However, the SRT of PD patients was slower under incongruent condition than under congruent condition. It appears that PD spent time on judgment in under incongruent condition because the meaning of the character did not correspond to the color of the character. Because, there were no significant between PD and healthy elderly subjects in Stroop test, WFT, and GDS, frontal lobe function had a partial deficit. The SRT of PD was increased by the partial deficit in information processing ability in addition to movement dysfunction.

Anosognosia in Alzheimer's disease: Association with patient characteristics, psychiatric symptoms and cognitive deficits

Anosognosia is one of the major problems in the treatment and care of Alzheimer's disease (AD) patients. The aim of the study was to determine the patient characteristics, psychiatric symptoms, and cognitive deficits associated with anosognosia, because these are currently poorly understood. Eighty-four patients who met the National Institute of Neurological and Communicative Disease and Stroke-Alzheimer's Disease and Related Disorders Association criteria for probable AD were examined for anosognosia based on the difference between questionnaire scores of the patient and their caregiver. The relationship of anosognosia with patient characteristics (age, age at onset, duration of illness, education, Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), Hyogo Activities of Daily Living Scale (HADLS)), psychiatric symptoms (Neuropsychiatric Inventory (NPI), Geriatric Depression Scale (GDS)), and cognitive function (Digit Span, Word Fluency Test, Trail Making Test, Stroop Test, Raven's Coloured Progressive Matrices Test) were studied. Anosognosia showed positive correlations with age, age at onset, duration of illness, CDR, HADLS, and NPI disinhibition, and negative correlations with MMSE and GDS. Regarding cognitive function, only Part III of the Stroop Test was a predictor of anosognosia. The severity of anosognosia increased with disease progression and with a later age at onset. Subjective complaints of depression requiring self-monitoring of mood tended to decrease and, in contrast, inhibition of socially unsuitable behavior became more difficult as anosognosia worsened. Regarding cognitive function, anosognosia appeared to be associated with response inhibition impairment. Both disinhibition, as a psychiatric symptom, and response inhibition impairment are known to be correlated with disturbance of orbitofrontal function, which therefore may be associated with anosognosia.

Cognitive function during substitution treatment

For many patients substitution therapy provides the stability to initiate life style changes necessary to obtain steady employment and function in society. A critical question is the extent to which drug dependence is associated with impairments in cognitive performance which might affect daily functioning. In our randomized clinical trial 46 opiate dependent patients were randomly assigned to buprenorphin (BUP) (n=22) or methadone treatment (MMP) (n=24). Cognitive performance (attention, concentration, working memory, cognitive speed) was evaluated at baseline during the first week of treatment (t1) and after 8–10 weeks of stable treatment (t2) and compared to a control group that closely matched the clinical group on the variables age, gender and education. BUP and MMP patients under stable treatment reached significantly worse results in trail making test (A and B), Verbal Learning and Memory test, d2– test and some trials of Regensburg Word Fluency test compared to healthy controls. BUP and MMP–group could improve their concentration in d2–test under stable treatment (p<0,001). No major differences between BUP and MMP group were observed under stable treatment. A number of studies before have described cognitive impairment and deficits in MMP patients (for example Darke, S. (2000), Lyvers M (2003), Davis (2002)), but not for BUP patients. Addicts treated with buprenorphine often describe an increased alertness compared to methadone treatment. That could not be objectified in our testings. Our results indicate that Buprenorphine is comparable to methadone in regard to cognitive function. Both groups could improve their concentation in d2–test under stable treatment. There are some limitations to this study basically due to the small number of patients tested and the high number of comorbid substance abuse.

Gender Differences in Relations of Mental Rotation, Verbal Fluency, and SAT Scores to Finger Length Ratios as Hormonal Indexes

One hundred thirty-four university students (93 women, 41 men) were administered the Vandenberg Mental Rotation Test and the Thurstone Word Fluency Test, and they were asked to report their Scholastic Achievement Test scores. Finger lengths were measured, because literature has reported gender differences in the ratio of the 2nd to 4th, 2nd to 3rd, and 2nd to 5th finger lengths, such that the ratio is larger in women than in men. The goal of this study was to evaluate the relations between finger-length ratios and cognitive skills, such as spatial skills and verbal fluency, which have shown gender differences and direct relations to hormonal effects. Gender differences were found in the expected directions, such that the men performed better than the women for mental rotation, the women performed better than the men for verbal fluency, and the finger-length ratios were in the directions reported in the literature. The finger-length ratios showed an interesting relation with the cognitive variables for the men and women. For the men, better performance on the measures, including mental rotation, verbal fluency, and verbal Scholastic Achievement Test score was associated with less of a male-typical finger-length ratio pattern, or higher ratios. For the women, better performance for mental rotation and verbal fluency was associated with less of a female-typical finger-length ratio pattern, or lower ratios. Thus, in this group of college students, better cognitive performance was associated with a less gender-typical finger-length ratio, for both men and women. These findings are discussed in the context of other similar reports and a possible curvilinear relation between hormones and cognition in normal populations.

The differential effects of ecstasy/polydrug use on executive components: shifting, inhibition, updating and access to semantic memory

Recent theoretical models suggest that the central executive may not be a unified structure. The present study explored the nature of central executive deficits in ecstasy users. In study 1, 27 ecstasy users and 34 non-users were assessed using tasks to tap memory updating (computation span; letter updating) and access to long-term memory (a semantic fluency test and the Chicago Word Fluency Test). In study 2, 51 ecstasy users and 42 non-users completed tasks that assess mental set switching (number/letter and plus/minus) and inhibition (random letter generation). MANOVA revealed that ecstasy users performed worse on both tasks used to assess memory updating and on tasks to assess access to long-term memory (C- and S-letter fluency). However, notwithstanding the significant ecstasy group-related effects, indices of cocaine and cannabis use were also significantly correlated with most of the executive measures. Unexpectedly, in study 2, ecstasy users performed significantly better on the inhibition task, producing more letters than non-users. No group differences were observed on the switching tasks. Correlations between indices of ecstasy use and number of letters produced were significant. The present study provides further support for ecstasy/polydrug-related deficits in memory updating and in access to long-term memory. The surplus evident on the inhibition task should be treated with some caution, as this was limited to a single measure and has not been supported by our previous work.

Cerebral MRI findings and cognitive functioning

To examine the association between prevalent cerebral abnormalities identified on MRI and cognitive functioning in a predominantly middle-aged, population-based study cohort. Cerebral MRI was performed on 1,538 individuals (aged 55 to 72) from the Atherosclerosis Risk in Communities (ARIC) cohort, with no history of stroke or TIA, at study sites in Forsyth County, NC, and Jackson, MS. White matter hyperintensities (WMHs), ventricular size, and sulcal size were graded by trained neuroradiologists on a semiquantitative, 10-point scale. Cognitive functioning was assessed using the Delayed Word Recall Test (DWRT), Digit Symbol Substitution Test (DSST), and Word Fluency Test (WFT). High ventricular grade was independently associated with significantly lower scores on the DWRT and DSST and greater risk (odds ratio [OR] 2.32, 95% confidence interval [CI] 1.51 to 3.56) of impaired scores (i.e., < or =10th percentile) on the DWRT. High sulcal grade was associated with a modest decrement in scores on the DWRT. The presence of coexisting high grade WMHs and silent infarcts was independently associated with lower scores on all cognitive tests and greater risk of impaired functioning on the DSST (OR 2.91, 95% CI: 1.23 to 6.89) and WFT (OR 2.28, 95% CI 1.03 to 5.08). The presence of two or more high-grade abnormalities was associated with increased risk of impaired functioning on all cognitive tests (DWRT: OR 2.23, 95% CI 1.40 to 3.55; DSST: OR 2.06, 95% CI 1.13 to 3.76; WFT: OR 2.07, 95% CI 1.23 to 3.49) independent of multiple covariates and silent infarcts. Common changes in brain morphology are associated with diminished cognitive functioning in middle-aged and young-elderly individuals.

Cognitive function predicts first-time stroke and heart disease

To investigate whether impaired cognitive function is an early manifestation of vascular injury in the brain and therefore predicts risk of subsequent cardiovascular disease. The study population consisted of 12,096 middle-aged participants in the Atherosclerosis Risk in Communities (ARIC) Study who had no history of stroke or coronary heart disease (CHD) at the time of cognitive testing. Cognitive function was measured using the Digit-Symbol Substitution Test (DSST), the Word Fluency Test, and the Delayed Word Recall Test. Cognitive test scores were adjusted for demographic factors and then evaluated as predictors of incident cardiovascular events using Cox proportional hazards analysis. Over a median follow-up period of 6.4 years, there were 516 incident cardiovascular events (292 myocardial infarctions, 50 CHD deaths, and 174 strokes), resulting in an average annual incidence rate of 0.7%. Lower adjusted scores on each cognitive test predicted a greater risk of incident cardiovascular events after controlling for established vascular risk factors (highest vs lowest quartile DSST, adjusted hazard ratio 1.56, 95% CI 1.23 to 1.97, p for linear trend by quartile < 0.001). The magnitude of the association was comparable with other commonly used predictors of vascular risk such as left ventricular hypertrophy on EKG and high-density lipoprotein cholesterol level of <35 mg/dL. Cognitive test scores below demographic norms predict incident cardiovascular disease in middle-aged subjects independently of established vascular risk factors.

Qualitative Evaluation of Divergent Thinking in Patients with Schizophrenia

Patients with schizophrenia show deficits across a broad spectrum of neurocognitive domains. In particular, deficits in verbal fluency are common. Verbal fluency tests are neuropsychological tests that assess frontal lobe function or executive function but also assess divergent thinking. However, few studies have considered the impairment of verbal fluency from the viewpoint of divergent thinking. To consider the structure of divergent thinking, not only verbal assessments but also non-verbal assessments are indispensable. We administered several fluency tests, the idea fluency test, the design fluency test, and word (letter and category) fluency tests to 26 patients with schizophrenia and 26 healthy control subjects to evaluate divergent thinking in both groups and assessed their responses qualitatively. An acceptable minimal level of intelligence was maintained in the patient group. Although attention and executive functioning were relatively preserved in the subjects with schizophrenia, they demonstrated significant deficits in divergent thinking and had particular difficulty in producing ideas and designs requiring concept flexibility, a conversion of viewpoint, originality, or novelty. Research on deficits in divergent thinking in patients with schizophrenia may contribute to the development of cognitive and behavioral rehabilitation programs.

Cognitive Test Battery of Cascade: Tasks and Data

This paper presents the cognitive test battery used in the Cascade Study (Cardiovascular Determinants of Dementia) for examining the consequences of cerebral white matter lesions and atrophy. The test battery includes nine different tasks assessing memory, executive function, and global cognitive function. Three episodic memory tasks were used in combinations to assess the role of attention and speed on encoding. Estimates of short- and long-term memory capacity were also derived from these three memory tasks. Semantic memory production / frontal lobe functions were assessed by means of a word fluency test. The Letter Digit Substitution test and the Stroop test were used to assess speed of processing and attention. Motor speed was measured with the Purdue Pegboard test, and global cognitive function was assessed by the Mini Mental State Examination. Overall performance data for the whole Cascade sample and for each of eight study centers are presented for each test. Possible reasons for performance differences among study centers are discussed.