Spanish Multicenter Normative Studies (NEURONORMA Project): Norms for Verbal Fluency Tests

Abstract

Lexical fluency tests are frequently used in clinical practice to assess language and executive function. As part of the Spanish multicenter normative studies (NEURONORMA project), we provide age- and education-adjusted norms for three semantic fluency tasks (animals, fruit and vegetables, and kitchen tools), three formal lexical tasks (words beginning with P, M, and R), and three excluded letter fluency tasks (excluded A, E, and S). The sample consists of 346 participants who are cognitively normal, community dwelling, and ranging in age from 50 to 94 years. Tables are provided to convert raw scores to age-adjusted scaled scores. These were further converted into education-adjusted scaled scores by applying regression-based adjustments. The current norms should provide clinically useful data for evaluating elderly Spanish people. These data may also be of considerable use for comparisons with other international normative studies. Finally, these norms should help improve the interpretation of verbal fluency tasks and allow for greater diagnostic accuracy.

Unconstrained, phonemic and semantic verbal fluency: age and education effects, norms and discrepancies

“…A great majority of studies found an age-related decline in performance of phonemic and semantic VFT, as demonstrated by the metanorms of Loonstra, Tarlow and Sellers (2001), in accordance with fi ndings from further research (Bryan, Luszcz, & Crawford, 1997;Butman, Allegri, Harris, & Drake, 2000;Lanting, Haugrud, & Crossley, 2009;Peña-Casanova et al, 2009). Conversely, there is evidence of an education effect, showing that highly educated outperform low education individuals (Buriel, Gramunt Fombuena, Böhm, Rodés, & Peña-Casanova, 2004;Butman et al, 2000;Kosmidis, Vlahou, Panagiotaki, & Kiosseoglou, 2004;Peña-Casanova et al, 2009;Rami, Serradell, Bosch, Villar, & Molinuevo, 2007;Van Der Elst, Van Boxtel, Van Breukelen, & Jolles, 2006;Villodre et al, 2006).…”

“…A great majority of studies found an age-related decline in performance of phonemic and semantic VFT, as demonstrated by the metanorms of Loonstra, Tarlow and Sellers (2001), in accordance with fi ndings from further research (Bryan, Luszcz, & Crawford, 1997;Butman, Allegri, Harris, & Drake, 2000;Lanting, Haugrud, & Crossley, 2009;Peña-Casanova et al, 2009). Conversely, there is evidence of an education effect, showing that highly educated outperform low education individuals (Buriel, Gramunt Fombuena, Böhm, Rodés, & Peña-Casanova, 2004;Butman et al, 2000;Kosmidis, Vlahou, Panagiotaki, & Kiosseoglou, 2004;Peña-Casanova et al, 2009;Rami, Serradell, Bosch, Villar, & Molinuevo, 2007;Van Der Elst, Van Boxtel, Van Breukelen, & Jolles, 2006;Villodre et al, 2006). However, some investigations present different fi ndings (Buriel et al, 2004;Hughes & Bryan, 2002;Machado et al, 2009;Steiner, Mansur, Brucki, & Nitrini, 2008;Tallberg, Ivachova, Tingha, & Östberg, 2008;Tombaugh, Kozak, & Rees, 1999;Villodre et al, 2006), most likely due to population sampling and data analysis heterogeneous methods, such as reduced time for word searching.…”

Phonemic and semantic verbal fluency tasks: normative data for elderly Brazilians

“…In phonemic fl uency were evaluated primarily production and language fl uency skills, while in semantic verbal fl uency observed semantic memory skills (Peña-Casanova et al, 2009). However, both forms are associated with executive functions (Schlindwein-Zanini, 2010), since they require self-regulation, working memory, processing speed and organization (Magila & Caramelli, 2001).…”

Edad, escolarización y tareas de Fluencia Verbal para el screening de pacientes con Enfermedad de Alzheimer

“…Sus principales inconvenientes son la influencia de variables sociodemográficas (edad, sexo, nivel educativo) (Tombaugh, Kozak, & Rees, 1999), culturales (Carnero-Pardo, 2000;Carnero-Pardo & Del Ser, 2007;Carnero, 1999;Peña-Casanova, et al, 2009;Ramírez, et al, 2005;Steenhuis & Ostbye, 1995) y de las circunstancias de la aplicación externas (temperatura de la sala, distracciones durante la prueba…) e internas (estado anímico, ansiedad, motivación…) que pueden afectar a la validez clínica de la prueba. Para mejorar su fiabilidad se ha propuesto un método estandarizado de aplicación que minimiza los efectos derivados de la administración y de la calificación de las pruebas (Ramírez, et al, 2005).…”

“…Las tareas de FVS emplean habitualmente las categorías de "animales", "cosas que hay en una casa" (Fernández, et al, 2002), "frutas y vegetales", "utensilios de cocina" (Peña-Casanova, et al, 2009), "cosas que se pueden encontrar en un supermercado" (Garcés-Redondo, Santos, Pérez-Lázaro, & Pascual-Millán, 2004) y "nombres de persona" (Sáez-Zea, Carnero-Pardo, & Gurpegui, 2008). En esta misma línea, el set-test (Pascual Millán, et al, 1990) incluye cuatro categorías ("colores", "animales", "frutas" y "ciudades"), se ha validado en España y es aplicable a personas con baja escolaridad.…”