Measures of fluency as predictors of incidental memory among older adults.

This study investigated fluency performance as a mediator of age-related declines in incidental memory performance as both are thought to rely on strategic retrieval processes. A large sample of community dwelling older adults completed a battery of tests assessing fluency, verbal knowledge, speed of information processing, and incidental recall. Fluency measures included initial and excluded letter fluency and the Uses for Objects Test, and they were assumed to reflect increasing reliance on strategic retrieval search. Speed emerged as the best mediator of age-related variance in incidental recall, and Uses for Objects Test performance added to the variance after controlling for verbal knowledge and speed. The results suggest that age-related decline in incidental recall is largely due to speed and the strategic search of memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Verbal knowledge and speed of information processing as mediators of age differences in verbal fluency performance among older adults.

Age-related declines in verbal fluency among a large sample of older adults were investigated. Background variables, verbal knowledge, and speed of processing were examined as predictors of verbal fluency and as mediators of age effects. As expected, age-related declines were greater on the excluded letter fluency task than on the initial letter fluency task. Verbal knowledge was a better predictor of initial letter fluency than speed of processing, whereas the reverse was true for excluded letter fluency. However, speed of processing-accounted for more of the age-related variance in both fluency measures than the other predictors. There was no evidence of verbal knowledge compensating for age-related declines in verbal fluency. Results suggest that verbal fluency performance is well maintained in late life and that any age-related decline appears to be mainly due to declines in speed of information processing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The structure of verbal abilities in young and older adults.

Four language sample measures as well as measures of vocabulary, verbal fluency, and memory span were obtained from a sample of young adults and a sample of older adults. Factor analysis was used to analyze the structure of the vocabulary, fluency, and span measures for each age group. Then an "extension" analysis was performed by using structural modeling techniques to determine how the language sample measures were related to the other measures. The measure of grammatical complexity was associated with measures of working memory including reading span and digit span. Two measures, sentence length in words and a measure of lexical diversity, were associated with the vocabulary measures. The fourth measure, propositional density, was associated with the fluency measures as a measure of processing efficiency. The structure of verbal abilities in young and older adults is somewhat different, suggesting age differences in processing efficiency. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of working memory capacity in retrieval.

The verbal fluency task that requires generation of category exemplars and appears to be an example of what M. Moscovitch (1995) calls a strategic test of memory retrieval. Four experiments explored the role of individual differences in working memory (WM) capacity on verbal fluency under various secondary load conditions. High WM participants consistently recalled more exemplars. However, load conditions caused a decline in recall only for high WM participants. Low WM participants showed no effect of secondary workload on exemplar generation. WM group differences and load effects were observed even in the 1st min of retrieval, which suggests that differences were not due to differences in knowledge. A model of retrieval is supported that relies on cue-based-automatic activation, monitoring of output for errors, controlled suppression of previously recalled items, and controlled strategic search. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Big" versus "little" science: comparative analysis of program projects and individual research grants

The verbal fluency task requires generation of category exemplars and appears to be an example of what M. Moscovitch (1995) calls a strategic test of memory retrieval. Four experiments explored the role of individual differences in working memory (WM) capacity on verbal fluency under various secondary load conditions. High WM participants consistently recalled more exemplars. However, load conditions caused a decline in recall only for high WM participants. Low WM participants showed no effect of secondary workload on exemplar generation. WM group differences and load effects were observed even in the 1st min of retrieval, which suggests that differences were not due to differences in knowledge. A model of retrieval is supported that relies on cue-based-automatic activation, monitoring of output for errors, controlled suppression of previously recalled items, and controlled strategic search.     

Selective use of the Eight-Word subtest in psychogeriatrics

Performance on the Amsterdam Dementia Screening Test (ADS) and the Expanded Mental Control Test (EMCT) was examined in a consecutive sample of 204 attendants of a psychogeriatric day care department. The ADS has six subtests: picture recognition, orientation, drawing alternating sequences, category fluency, copying geometric figures, and free recall with immediate yes-no recognition of eight words. As was determined by logistic regression analysis, attentional control (EMCT), category fluency and picture recognition scores were significant predictors of verbal free recall. Recognition memory for pictures and a short orientation questionnaire (month, year, place) predicted word recognition performance. In 97% of the subjects with poor scores on EMCT and category fluency, an equally poor free recall performance was found. In those cases the incremental diagnostic value of the free recall test is doubtful. Since word recall and word recognition were conceptually related to working memory and episodic memory respectively, the two components of the verbal learning test allow detection of differential impairments of these memory systems.     

Understanding verbal fluency in healthy aging, Alzheimer's disease, and Parkinson's disease.

Objective: Verbal fluency measures are frequently part of batteries designed to assess executive function (EF), but are also used to assess semantic processing ability or word knowledge. The goal of the present study was to identify the cognitive components underlying fluency performance. Method: Healthy young and older adults, adults with Parkinson's disease, and adults with Alzheimer's disease performed letter, category, and action fluency tests. Performance was assessed in terms of number of items generated, clustering, and the time course of output. A series of neuropsychological assessments were also administered to index verbal ability, working memory, EF, and processing speed as correlates of fluency performance. Results: Findings indicated that regardless of the particular performance measure, young adults performed the best and adults with Alzheimer's disease performed most poorly, with healthy older adults and adults with Parkinson's disease performing at intermediate levels. The exception was the action fluency task, where adults with Parkinson's disease performed most poorly. The time course of fluency performance was characterized in terms of slope and intercept parameters and related to neuropsychological constructs. Speed of processing was found to be the best predictor of performance, rather than the efficiency of EF or semantic knowledge. Conclusions: Together, these findings demonstrate that the pattern of fluency performance looks generally the same regardless of how performance is measured. In addition, the primary role of processing speed in performance suggests that the use of fluency tasks as measures of EF or verbal ability warrants reexamination. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Individual memory change after anterior temporal lobectomy: a base rate analysis using regression-based outcome methodology

PURPOSE: To characterize patterns of base rate change on measures of verbal and visual memory after anterior temporal lobectomy (ATL) using a newly developed regression-based outcome methodology that accounts for effects of practice and regression towards the mean, and to comment on the predictive utility of baseline memory measures on postoperative memory outcome. METHODS: Memory change was operationalized using regression-based change norms in a group of left (n = 53) and right (n = 48) ATL patients. All patients were administered tests of episodic verbal (prose recall, list learning) and visual (figure reproduction) memory, and semantic memory before and after ATL. RESULTS: ATL patients displayed a wide range of memory outcome across verbal and visual memory domains. Significant performance declines were noted for 25-50% of left ATL patients on verbal semantic and episodic memory tasks, while one-third of right ATL patients displayed significant declines in immediate and delayed episodic prose recall. Significant performance improvement was noted in an additional one-third of right ATL patients on delayed prose recall. Base rate change was similar between the two ATL groups across immediate and delayed visual memory. Approximately one-fourth of all patients displayed clinically meaningful losses on the visual memory task following surgery. Robust relationships between preoperative memory measures and nonstandardized change scores were attenuated or reversed using standardized memory outcome techniques. CONCLUSIONS: Our results demonstrated substantial group variability in memory outcome for ATL patients. These results extend previous research by incorporating known effects of practice and regression to the mean when addressing meaningful neuropsychological change following epilepsy surgery. Our findings also suggest that future neuropsychological outcome studies should take steps towards controlling for regression-to-the-mean before drawing predictive conclusions.     

Neuropsychological functioning in HIV-positive African-American women with a history of drug use

This preliminary investigation examined neuropsychological performance in a sample of human immunodeficiency virus (HIV)-positive and HIV-negative African-American women with a history of drug use. The study population was comprised of 10 HIV-negative, 9 asymptomatic HIV-positive, 13 symptomatic HIV-positive, and 10 acquired immunodeficiency virus (AIDS) patients. A neuropsychological battery designed to assess attention, psychomotor processing, verbal memory, and visual memory was administered to participants. No evidence of HIV-related cognitive impairment was found in patients in the early stages of HIV infection. Multivariate analyses of variance revealed significant deficits in psychomotor processing and verbal recall in persons with AIDS. These individuals showed greater difficulty in tasks requiring maintained attention and performed poorly on measures of immediate and delayed verbal recall. In contrast, HIV status was not related to visual memory, verbal recognition, or the number of errors made during a verbal recall task. The pattern of cognitive deficits observed in persons with AIDS resembles that commonly associated with subcortical pathology. The cognitive deficits observed were not related to depression or recentness of drug use.     

Commonalities and differences in the working memory components underlying letter and category fluency tasks: A dual-task investigation.

This study used a dual-task interference paradigm to test the hypothesis that different subcomponents of working memory differentially contribute to performance on letter fluency and category fluency tasks. College students (N = 96) performed each type of verbal fluency task in isolation and concurrently with I of 3 secondary tasks. The secondary tasks were chosen for their putative involvement in different working memory subcomponents. Two subsystems of working memory, the phonological loop and the visuospatial sketchpad, were identified as important contributors to fluency performance, especially to performance on letter fluency and category fluency tasks, respectively. Moreover, the results also suggest that the executive function, mental set shifting, may be deployed to perform both letter fluency and category fluency tasks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Serum uric acid and cognitive function in community-dwelling older adults.

Among possible markers of age-related cognitive decline, uric acid (UA) is controversial because it has antioxidant properties but is increased in diseases that often lead to cognitive impairment. In this study of 96 elderly adults, participants with mildly elevated (but normal) serum UA were 2.7 to 5.9 times more likely to score in the lowest quartile of the sample on measures of processing speed, verbal memory, and working memory. Even after controlling for age, sex, race, education, diabetes, hypertension, smoking, and alcohol abuse, the multivariate-adjusted odds of poor verbal memory and working memory remained significant (ps     

Verbal fluency deficits in geriatric and nongeriatric chronic schizophrenic patients

This study examined age-related differences and correlates of deficits on phonological and category fluency tasks performed by schizophrenic patients. Equal numbers (n = 41) of geriatric (age > 64) and nongeriatric chronically hospitalized schizophrenic patients were examined with tests of phonological and category fluency, verbal learning and delayed recall, confrontation naming, and reading, as well as overall estimates of cognitive impairment. Both types of fluency tests were performed very poorly by both groups. Age-related differences were found to be statistically significant. In both groups, category fluency impairments were correlated with deficits in naming, while phonological fluency deficits were best predicted by memory impairments. These data suggest that category fluency impairments are part of a general profile of impaired semantic functioning, whereas phonological fluency deficits may be induced by alterations in information processing capacity.     

The separability of working memory resources for spatial thinking and language processing: An individual differences approach.

The current study demonstrates the separability of spatial and verbal working memory resources among college students, In Experiment 1, we developed a spatial span task that taxes both the processing and storage components of spatial working memory. This measure correlated with spatial ability (spatial visualization) measures, but not with verbal ability measures. In contrast, the reading span test, a common test of verbal working memory, correlates with verbal ability measures, but not with spatial ability measures. Experiment 2, which uses an interference paradigm to cross the processing and storage demands of span tasks, replicates this dissociation and further demonstrates that both the processing and storage components of working memory tasks are important for predicting performance on spatial thinking and language processing tasks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Speech recognition and working memory capacity in young-elderly listeners: Effects of hearing sensitivity.

Young normal-hearing listeners and young-elderly listeners between 55 and 65 years of age, ranging from near-normal hearing to moderate hearing loss, were compared using different speech recognition tasks (consonant recognition in quiet and in noise, and time-compressed sentences) and working memory tasks (serial word recall and digit ordering). The results showed that the group of young-elderly listeners performed worse on both the speech recognition and working memory tasks than the young listeners. However, when pure-tone audiometric thresholds were used as a covariate variable, the significant differences between groups disappeared. These results support the hypothesis that sensory decline in young-elderly listeners seems to be an important factor in explaining the decrease in speech processing and working memory capacity observed at these ages. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuroanatomical correlates of cognitive aging: Evidence from structural magnetic resonance imaging.

To examine putative brain substrates of cognitive functions differentially affected by age, the authors measured the volume of cortical regions and performance on tests of executive functions, working memory, explicit memory, and priming in healthy adults (18-77 years old). The results indicate that shrinkage of the prefrontal cortex mediates age-related increases in perseveration. The volume of visual processing areas predicted performance on nonverbal working memory tasks. Contrary to the hypotheses, in the examined age range, the volume of limbic structures was unrelated to any of the cognitive functions; verbal working memory, verbal explicit memory, and verbal priming were independent of cortical volumes. Nevertheless, among the participants aged above 60, reduction in the volume of limbic structures predicted declines in explicit memory. Chronological age adversely influenced all cognitive indices, although its effects on priming were only indirect, mediated by declines in verbal working memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal deficits to attention, executive, and working memory in subtypes of mild cognitive impairment.

Objective: Mild cognitive impairment (MCI) has emerged as a classification for a prodromal phase of cognitive decline that may precede the emergence of Alzheimer's disease (AD). Recent research suggests that attention, executive, and working memory deficits may appear much earlier in the progression of AD than traditionally conceptualized, and may be more consistently associated with the later development of AD than memory processing deficits. The present study longitudinally tracked attention, executive and working memory functions in subtypes of MCI. Method: In a longitudinal study, 52 amnestic MCI (a-MCI), 29 nonamnestic MCI (na-MCI), and 25 age- and education-matched controls undertook neuropsychological assessment of visual and verbal memory, attentional processing, executive functioning, working memory capacity, and semantic language at 10 month intervals. Results: Analysis by repeated measures ANOVA indicate that the a-MCI and na-MCI groups displayed a decline in simple sustained attention (ηp2 = .054) with a significant decline on a task of divided attention (ηp2 = .053) being evident in the a-MCI group. Stable deficits were found on other measures of attention, working memory and executive function in the a-MCI and na-MCI groups. The a-MCI group displayed stable impairments to visual and verbal memory. Conclusions: The results indicate that a-MCI and na-MCI display a stable pattern of deficits to attention, working memory, and executive function. The decline in simple sustained attention in a-MCI and n-MCI groups and to divided attention in a-MCI may be early indicators of possible transition to dementia from MCI. However, further research is required to determine this. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Cognitive correlates of mortality: Evidence from a population-based sample of very old adults.

The authors examined performance on memory, visuospatial, and verbal tasks and subsequent mortality in adults 75–95 years. The sample consisted of 178 living and 44 deceased participants. Mean-level analyses revealed mortality group differences for all domains of cognitive functioning. A Cox regression analysis, independent of age, gender, education, functional ability, and chronic illness, indicated that measures of word recognition and category fluency were significant predictors of mortality status. The results indicate a relationship between cognitive performance and subsequent mortality status in very old age and suggest that episodic memory and verbal skill may be particularly sensitive in predicting such effects. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Executive Functioning, Memory, and Learning in Phenylketonuria.

The executive deficit hypothesis of treated phenylketonuria (PKU) suggests that dopaminergic depletion in the lateral prefrontal cortex leads to selective executive impairment. This was examined by comparing adults with PKU on a lifelong diet with a matched healthy control group. Those with PKU were impaired on selective and sustained attention, working memory (Self-Ordered Pointing), and letter fluency. However, they failed to show differential sensitivity to increased cognitive load on the attentional and working memory tasks, and they did not differ significantly on the remaining executive tasks (rule finding, inhibition, and multitasking). Nor did they differ significantly on recall or recognition memory. Overall, the findings provided little support for the executive deficit hypothesis. A possible explanation in terms of slowed information processing speed is explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Investigation of functional working memory in the reading span test.

Two issues were investigated in 2 experiments: (1) the validity of a reading span test that combined a knowledge verification task with a secondary task of word memorization and (2) the hypothesis that word recall reflects the amount of working memory that is functional in reading. In Exp 1, the validity and reliability of the reading span measure were determined. In Exp 2, it was reasoned that if word recall reflected functional working memory in reading, then 2 results should be observed. The 1st predicted result was that prior exposure to sentences used in the reading span test would release working memory resources and improve word recall. The 2nd was that word recall, though correlated with general working memory and verbal knowledge measures, would add to these scores in predicting comprehension. Both sets of results were obtained, supporting the hypothesis that the reading span test measures functional working memory in reading. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of modafinil treatment on neuropsychological and attentional bias performance during 7-day inpatient withdrawal from methamphetamine dependence.

The cognitive benefits of modafinil to patients undergoing 7-day inpatient withdrawal from methamphetamine (MA) dependence were examined as part of a double-blind, randomized, placebo-controlled pilot trial. Recent evidence has identified modafinil-related improvements in treatment outcomes for MA-dependent patients; however, the benefits to cognition function, which is critical to treatment success but known to be impaired, has yet to be examined. The first 20 participants recruited to the study were administered either 200 mg of modafinil (once daily) or placebo, and a neuropsychological test battery (including an MA version of the emotional Stroop task) at admission (n = 17) and discharge (n = 14). Follow-up interviews were conducted at 1-month postdischarge (n = 13). After participant withdrawals (3 in each group), treatment was associated with a significant improvement in immediate verbal memory recall and nonsignificant trend toward improvement on executive function and delayed memory tasks. No benefit was seen for measures of verbal learning, visual memory, processing speed, or verbal fluency. All participants showed a significant attentional bias for MA-related stimuli on the emotional Stroop task. The magnitude of bias predicted both retention in treatment and relapse potential at follow-up but was not significantly ameliorated by modafinil treatment. While nonsignificant, the effect sizes of modafinil-related improvements in executive function and memory were consistent with those found in more robustly powered studies of cognitive benefits in attention-deficit/hyperactivity disorder and schizophrenia, supporting the need for further research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)