Working Memory and Perseveration in Verbal Fluency.

Letter and semantic fluency tasks are often used in neuropsychological assessment and are sensitive to many conditions. Performance is assessed by correct responses and errors, including perseverations. Healthy young adults performed letter and semantic fluency tasks. One group performed these tasks in the conventional manner; 2 other groups performed them while maintaining memory loads. The memory loads consisted either of words from the same category as the fluency task or of words from a different category. The results showed little effect of memory loads on correct responses but significant effects of memory load on perseveration rates: Same-category loads resulted in higher rates, especially in letter fluency. The results are discussed in terms of frontal lobe function in verbal fluency. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Performance of everyday actions in mild Alzheimer's disease.

Early neuropsychological deficits associated with mild Alzheimer's disease (AD) have been characterized as memory deficits and impaired executive function or attention. The functional impact of early impairment was investigated by evaluating performance of everyday actions in older adults with mild AD (n = 15) as compared with healthy age-matched controls (n = 16). Everyday actions were familiar activities, for example, making a cup of tea, but were varied in complexity (simple, complex) and were performed under varied attention demand (single task, dual task). Although both participant groups responded to increasing task complexity by making more errors, the AD group made more errors under dual-task conditions regardless of the complexity of the task. Furthermore, a task requiring strategic retrieval of semantic information from long-term memory and manipulation of attention online (category fluency) was able to account for a large proportion of the group-related variance in everyday task performance. Results are discussed in relation to the role of components of working memory in performance of everyday actions in mild AD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disparate letter and semantic category fluency deficits in autopsy-confirmed frontotemporal dementia and Alzheimer's disease.

Patients with autopsy-confirmed frontotemporal dementia (FTD; n = 16) and Alzheimer's disease (AD; n = 32) were compared on first-letter and semantic category fluency tasks. Despite being matched on age, education, and dementia severity, FTD patients performed worse overall and showed similar impairment in letter and semantic category fluency, whereas AD patients showed greater impairment in semantic category than letter fluency. A measure of the disparity between letter and semantic category fluency (the semantic index) was effective in differentiating FTD from AD patients, and this disparity increased with increasing severity of dementia. These unique patterns of letter and semantic category fluency deficits may be indicative of differences in the relative contribution of frontal-lobe-mediated retrieval deficits and temporal-lobe-mediated semantic deficits in FTD and AD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clustering and switching as two components of verbal fluency: Evidence from younger and older healthy adults.

Although verbal fluency is a frequently used neuropsychological test, little is known about the underlying cognitive processes. The authors proposed that 2 important components of fluency performance are clustering (i.e., the production of words within semantic or phonemic subcategories) and switching (i.e., the ability to shift between clusters). In Experiment 1, correlational data from 54 older and 41 younger adults indicated that both components were highly correlated with the number of words generated on semantic fluency, whereas switching was more highly correlated than clustering with the number of words generated on phonemic fluency. On semantic fluency, younger participants generated more words and switched more frequently than older participants; on phonemic fluency, older participants produced larger clusters than younger participants. In Experiment 2, among 22 young adults, divided attention decreased the number of words generated and decreased switching on phonemic fluency only. Overall, findings suggest that clustering and switching are dissociable fluency components and that switching is related to frontal-lobe functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Endothelial cells of the kidney vasa recta express the urea transporter HUT11

Although verbal fluency is a frequently used neuropsychological test, little is known about the underlying cognitive processes. The authors proposed that 2 important components of fluency performance are clustering (i.e., the production of words within semantic or phonemic subcategories) and switching (i.e., the ability to shift between clusters). In Experiment 1, correlational data from 54 older and 41 younger adults indicated that both components were highly correlated with the number of words generated on semantic fluency, whereas switching was more highly correlated than clustering with the number of words generated on phonemic fluency. On semantic fluency, younger participants generated more words and switched more frequently than older participants; on phonemic fluency, older participants produced larger clusters than younger participants. In Experiment 2, among 22 young adults, divided attention decreased the number of words generated and decreased switching on phonemic fluency only. Overall, findings suggest that clustering and switching are dissociable fluency components and that switching is related to frontal-lobe functioning.     

Phonemic fluency deficits in asymptomatic gene carriers for Huntington's disease.

The aim of the present study was to investigate verbal fluency in preclinical Huntington's disease (HD). Phonemic and semantic fluency and the rate of word production over time were assessed for 29 asymptomatic gene carriers and 34 noncarriers of HD. The relationship between fluency tasks and other cognitive domains was investigated. Compared to noncarriers, carriers produced fewer words and produced them more slowly in the phonemic fluency task but not in the semantic fluency task. When the carrier group was divided on the basis of Predicted-Years-To-Onset (PYTO), only carriers with     

Semantic fluency in Alzheimer's, Parkinson's, and Huntington's disease: Dissociation of storage and retrieval failures.

Patients with Alzheimer's disease (AD), Huntington's disease (HD), and Parkinson's disease (PD), and normal controls were compared on 2 versions of a semantic fluency task: a standard, uncued version and a version in which Ss were cued with subordinate categories. All patients were impaired relative to controls on the standard version. On the cued version, PD and HD patients improved significantly, but AD patients did not. AD patients' fluency, but not PD or HD patients', correlated significantly with confrontation naming ability. Impairment exhibited by PD and HD patients on standard semantic fluency tasks may be due to a retrieval deficit, whereas that of AD patients may be due to degradation of semantic memory stores. In addition, the pattern of performance exhibited by a nonaphasic patient with bilateral frontal lobe lesions suggests that the retrieval functions involved may depend on integrity of the prefrontal cortex. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychological effects of closed head injury in older adults: A comparison with Alzheimer's disease.

In this study, neuropsychological profiles of 14 older adult patients with mild or moderate closed head injury (CHI). 14 patients with probable Alzheimer's disease (AD), and 14 community residing elderly controls were compared. The groups were similar in demographic features, and the CHI and AD patients had comparable Mini-Mental State Examination scores. Tests of verbal learning and memory, letter and category fluency, and naming were administered. Relative to the CHI group, AD patients exhibited more devastated memory and did not show a normal facilitation on the category retrieval task. The patient groups exhibited similar levels of categorical clustering and naming accuracy for both high- and low-frequency words. These results suggest that neuropsychological markers of memory and semantic processing may be useful in differentiating the cognitive effects from AD versus early recovery from CHI. (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)     

A Meta-Analytic Review of Verbal Fluency Deficits in Huntington's Disease.

A meta-analysis of 30 studies with 1,511 participants was conducted to estimate and compare the magnitude of deficits on tests of phonemic and semantic fluency for patients with Huntington's disease (HD) relative to healthy control participants. As has been found for patients with focal frontal cortical lesions (but not for patients with focal temporal cortical lesions), symptomatic HD patients were comparably impaired on tests of phonemic and semantic fluency (rs=.71 and .73, respectively). However, in contrast to patients with focal frontal lobe injuries, fluency deficits did not qualify as differential deficits relative to verbal intelligence or psychomotor speed. Therefore, for patients with HD, deficits on tests of phonemic and semantic fluency do not appear to reflect executive dysfunction but a more generalized cognitive impairment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Verbal and nonverbal fluency in patients with probable Alzheimer's disease.

Verbal fluency (semantic category naming and letter fluency) and nonverbal fluency (semantic category drawing and design fluency) were measured in mildly and moderately demented patients with probable dementia of the Alzheimer type (pDAT), and related to age at onset, disease duration, and disease severity. Group and individual patient analyses revealed impairments within verbal and nonverbal modalities that were most severe on semantic category fluency tasks. Detailed assessments of errors emphasized the role of compromised semantic memory in pDAT patients' impaired fluency, regardless of the modality of response. Fluency performance was related to dementia severity but not to age of onset or disease duration. It is concluded that deficits on measures of fluency in pDAT are due in large part to semantic memory impairments and that fluency may be useful for following disease progression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparing the difficulty of letter, semantic, and name fluency tasks for normal elderly and patients with Parkinson's disease.

Research on the effect of Parkinson's disease (PD) on verbal fluency has produced conflicting results. In this study, 88 PD patients with no dementia, 11 PD patients with questionable mental status, 15 PD patients with dementia, and 46 elders free from mental disorder were administered a variety of semantic, letter, and name fluency tasks. The results revealed that, contrary to popular assumption, semantic fluency was not always superior to letter fluency. Rather, verbal fluency was influenced by the nature of the individual categories. Interestingly, the relative difficulty of many categories was fairly stable across groups. The results also indicated that the individual fluency tasks were differentially sensitive to the mental status of the PD patients. Overall, the findings suggest that closer attention to the nature of the tested categories may help clarify the inconsistent effects of PD on verbal fluency. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychological and psychiatric differences between Alzheimer's disease and Parkinson's disease with dementia

OBJECTIVE: To examine neuropsychological and neuropsychiatric differences between patients with probable Alzheimer's disease and patients with Parkinson's disease and dementia. METHODS: Thirty three patients with probable Alzheimer's disease and 33 patients with Parkinson's disease and dementia were matched for age, sex, and mini mental state examination scores and given a battery of neuropsychological and neuropsychiatric tests. RESULTS: Patients with Parkinson's disease with dementia had a significantly higher prevalence of major depression than patients with Alzheimer's disease; patients with Alzheimer's disease showed more severe anosognosia and disinhibition than patients with Parkinson's disease. Whereas no significant between group differences were found on tests of memory and language, demented patients with Parkinson's disease had a significantly greater impairment on a test of visual reasoning than patients with Alzheimer's disease. CONCLUSION: There were significant psychiatric differences between patients with Alzheimer's disease and demented patients with Parkinson's disease, but neuropsychological differences were restricted to a single cognitive domain.     

Selection Ability in Alzheimer's Disease: Investigation of a Component of Semantic Processing.

Selection ability (selecting a response from several competing semantic and/or lexical representations) was tested in 21 participants with Alzheimer's disease (AD) and 28 control participants to help clarify the nature of semantic impairments in AD. Selection demands were manipulated in 3 tasks (lexical fluency, comparison, and verb generation). In each, high-selection conditions required response selection from competing alternatives, whereas low-selection conditions had a reduced need for selection. Patients with AD were disproportionately impaired on the high-selection conditions of all tasks, even when this condition was easier. Selection deficits on verb generation were evident only relative to nonspeeded controls. Overall results indicate impaired semantic selection abilities in AD, which may contribute to poor performance on some semantic tasks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Naming from definition, semantic relevance and feature type: The effects of aging and Alzheimer's disease.

Objective: The principal aim of the present study was to evaluate the impact of semantic relevance and feature type on the ability to name from definition. Method: Thirty-two normal young subjects (Study 1) and 20 probable Alzheimer's disease patients (pAD) with 20 matched older controls (Study 2) were tested with verbal definitions consisting of 4 features, combining feature type (sensory vs. nonsensory) and semantic relevance (high vs. low). The subjects were asked to provide a name corresponding to the definition and to select which individual features they considered most important in justifying their answer. Results: Feature selection results showed that high-relevance features first (d = 2.13 in Study 1; d = 1.44 in Study 2) and nonsensory features second (d = 0.81 in Study 1; d = 0.36 in Study 2) were the main dimensions driving correct performance. Overall, naming performance was affected by the age of acquisition (AoA) of the concept, and differences between the groups in all measures were mainly quantitative. Conclusions: These findings suggest that semantic relevance and feature type are important feature dimensions in conceptual representation and in conceptual access and retrieval. Moreover, results suggest that the former dimension may be more important than the latter, at least in the case of naming from definition. Finally, these results extend previous findings with other tasks, supporting the importance of AoA for correct performance and suggesting that the poorer performance of pAD patients on semantic tasks may represent an exaggeration of difficulties found also in normal older subjects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptual false recognition in Alzheimer's disease.

Previous research has found that patients with probable Alzheimer's disease (AD) show lower levels of false recognition of semantic associates than do healthy older adults. To investigate whether this finding is attributable to semantic impairments in patients with AD, the authors examined false recognition of perceptually related novel objects with little semantic content in patients with AD and healthy older adults. By using corrected recognition scores to control for unrelated false alarms, it was found that patients with AD showed lower levels of both true and false recognition of novel objects than did older adults. These results suggest that the previous difference in false recognition of semantic associates observed between patients with AD and older adults is not entirely attributable to semantic memory deficits in patients with AD but may also involve poorly developed gist information in these patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Structural brain correlates of verbal and nonverbal fluency measures in Alzheimer's disease.

This study examined the relationships between regional brain volumes and semantic, phonological, and nonverbal fluency in 32 participants with Alzheimer's disease (AD). Object but not animal semantic fluency correlated with frontal and temporal gray matter volumes. Phonological fluency was not significantly associated with any brain volume examined. Nonverbal fluency was selectively associated with bilateral frontal gray matter volumes. Hippocampal volumes, although markedly reduced in these patients, were not related to any of the fluency measures. Results lend evidence to the importance of the frontal lobes in the directed generation of nonverbal and verbal exemplars by AD patients. Furthermore, both left and right-hemisphere regions contribute to the generation of verbal and nonverbal exemplars. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evidence for Intact Selective Attention in Alzheimer's Disease Patients Using a Location Priming Task.

Researchers examining selective attentional mechanisms in patients with Alzheimer's disease (AD) often report impairment in patients' ability to inhibit irrelevant or distracting information. However, in many studies reporting such failures, researchers used tasks that require semantic processing, which a large body of literature documents to be disrupted in AD. The authors of this study used a spatial location-priming task that minimized semantic processing to examine the phenomena of negative priming and facilitative priming in 13 AD patients and 13 healthy older adults. AD patients demonstrated facilitative and negative priming proportionately equivalent to that of older adults. These findings suggest that both the facilitative and inhibitory mechanisms involved in selective attention are preserved in patients with AD and can be revealed in tasks that minimize semantic processing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of semantic and perceptual encoding on recognition memory in Alzheimer's disease

Previous results from a population of patients with Alzheimer's disease (Dalla Barba and Goldblum, 1996) demonstrated that the ability of patients to make a semantic association between two items was significantly and positively correlated to their performance on a yes/no recognition task for the same items and that patients who were impaired on the semantic task did significantly worse on the recognition task than patients who were unimpaired on the semantic task. These findings gave support to a hierarchical model of organization of human memory in which episodic memory depends on the integrity of semantic memory. The present study further investigates the relationship between semantic memory deficits and episodic recognition memory in 15 patients with Alzheimer's disease and 15 controls, as a function of their semantic and perceptual encoding abilities and of their cognitive impairment in other domains. The results confirmed the previous findings and showed that, although patients heavily relied on perceptual analysis, this type of encoding did not enhance their recognition memory. Correlations analyses showed that some patients who were not impaired in the semantic association, but with particularly low scores on a verbal fluency task presented with a pattern, in recognition memory tasks, that suggests a possible early involvement of frontal lobes in this subgroup of patients.     

Measurement invariance of neuropsychological tests in diverse older persons.

Objective: Comparability of meaning of neuropsychological test results across ethnic, linguistic, and cultural groups is important for clinicians challenged with assessing increasing numbers of older ethnic minorities. We examined the dimensional structure of a neuropsychological test battery in linguistically and demographically diverse older adults. Method: The Spanish and English Neuropsychological Assessment Scales (SENAS), developed to provide psychometrically sound measures of cognition for multiethnic and multilingual applications, was administered to a community dwelling sample of 760 Whites, 443 African Americans, 451 English-speaking Hispanics, and 882 Spanish-speaking Hispanics. Cognitive function spanned a broad range from normal to mildly impaired to demented. Multiple group confirmatory factor analysis was used to examine equivalence of the dimensional structure for the SENAS across the groups defined by language and ethnicity. Results: Covariance among 16 SENAS tests was best explained by five cognitive dimensions corresponding to episodic memory, semantic memory/language, spatial ability, attention/working memory, and verbal fluency. Multiple Group confirmatory factor analysis supported a common dimensional structure in the diverse groups. Measures of episodic memory showed the most compelling evidence of measurement equivalence across groups. Measurement equivalence was observed for most but not all measures of semantic memory/language and spatial ability. Measures of attention/working memory defined a common dimension in the different groups, but results suggest that scores are not strictly comparable across groups. Conclusions: These results support the applicability of the SENAS for use with multiethnic and bilingual older adults, and more broadly, provide evidence of similar dimensions of cognition in the groups represented in the study. (PsycINFO Database Record (c) 2011 APA, all rights reserved)