Reduced Semantic Fluency as an Additional Screening Tool for Subjects with Questionable Dementia

Abstract

Background: Subjective memory complaints in subjects with mild cognitive impairment may represent a genuine decline in episodic memory. This paper evaluates the neuropsychological correlates of the semantic fluency test in subjects with questionable dementia (QD). Methods: A total of 331 Chinese subjects (118 normal controls, NC, 150 with QD and 63 with mild Alzheimer’s disease, AD) were assessed with the Category Verbal Fluency Test (CVFT), the AD Assessment Scale – cognitive subscale (ADAS-Cog), and digit and verbal span tests. CVFT performance was evaluated in each Clinical Dementia Rating (CDR) group. The total number of exemplars, the subcategory and the category size generated were evaluated. Neuropsychological correlates of CVFT scores were computed. Results: Significant differences in CVFT performance were found between the different CDR groups. The subjects with QD had intermediate scores compared to the NC and AD subjects (1-way ANOVA, p < 0.001, post-hoc Bonferroni comparisons). In NC the CVFT scores were significantly associated with ADAS-Cog total, and immediate and delayed recall scores (partial correlations controlled for age and education, p < 0.005). In the QD group the CVFT scores were correlated with ADAS-Cog total, and immediate recall and object naming scores (partial correlation controlled for age and education, p < 0.005). Regression analysis revealed that age and delayed recall were significant predictors of CVFT performance in NCs. In the QD group, age, ADAS-Cog immediate recall and object naming scores predicted the CVFT performance. Conclusions: The CVFT was impaired in the subjects with QD. Apart from episodic memory, semantic memory deficits also occur early in AD. The different cognitive predictors of CVFT scores in the NC and QD groups suggest that the test is associated with specific psychological functions at different stages of cognitive impairment.

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

“…Other studies have demonstrated that decreases in semantic fluency performance (e.g. animal naming) may be indicative of single-domain aMCI [12,13,14,15]. Some of these studies also found statistically significant decreases in letter fluency performance among those categorized as single-domain aMCI [9,13,14].…”

Degeneração Lobar Frontotemporal: Polêmicas E Desafios

“…Além disso, deve-se considerar que processos complexos como o reconhecimento de faces, o processamento emocional, o raciocínio sequencial e a fluência verbal por dependerem da memória semântica podem estar comprometidos nessa síndrome (JEFFERIES; PATTERSON; RALPH, 2006). Embora a memória episódica possa estar relativamente preservada (especialmente para material visual), sendo usada como suporte para reaprendizagem do conhecimento sobre palavras e objetos, artigos recentes também têm constatado déficits nessa área (TU et al, 2013;LAM et al, 2006;CAIXETA;MANSUR, 2005). Um estudo de Honolulu identificou sujeitos com queixas subjetivas de memória, déficits na memória episódica e fluência verbal três anos antes do estabelecimento clínico da DS (LAM et al, 2006).…”

“…Embora a memória episódica possa estar relativamente preservada (especialmente para material visual), sendo usada como suporte para reaprendizagem do conhecimento sobre palavras e objetos, artigos recentes também têm constatado déficits nessa área (TU et al, 2013;LAM et al, 2006;CAIXETA;MANSUR, 2005). Um estudo de Honolulu identificou sujeitos com queixas subjetivas de memória, déficits na memória episódica e fluência verbal três anos antes do estabelecimento clínico da DS (LAM et al, 2006). Na variante comportamental, contrariamente à noção popular de que a memória episódica estaria preservada, pesquisas têm encontrado prejuízo na codificação e consolidação de informações em estágios iniciais da doença (XIE et al, 2010;MATUSZEWSKI et al, 2006).…”

“…Está associada à atrofia assimétrica dos lobos temporais, com predileção específica para o neocórtex anterior, com atrofia variável do hipocampo (TU et al, 2013;LAM et al, 2006;AGOSTA et al, 2009;MANSUR, 2005). Considerada variante da afasia progressiva primária ou direta da DFLT, essa condição tem sido foco de extensas pesquisas há mais de uma década, embora pouco ainda se saiba sobre o perfil neuropsicológico dos pacientes com a síndrome.…”

Utility of the Clinical Dementia Rating in Asian Populations

“…70,71 Thus, the CDR 0.5 group is well placed for use in studies that seek to examine intermediate states between normal aging and dementia, such as MCI (table 2). 72 Available studies in Asian populations add to the growing body of evidence in Caucasian populations that the CDR 0.5 group is similar to very mild Alzheimer's disease with regards to cognitive features, 35,61,73 behavior, 67 psychometric performance, 72,74,75 and longitudinal progression, 35,37,76 as well as structural and functional neuroimaging characteristics. 41,42 Many of these studies utilize a more liberal definition of MCI that equates to CDR 0.5, although some studies subclassify the CDR 0.5 group into MCI not demented (corresponding to CDR 0.5 uncertain dementia) and MCI incipient dementia (equivalent to CDR 0.5 incipient or very mild dementia).…”