Phonemic verbal fluency tests assess the production of words beginning with specific letters. Of these letters, the most frequently used are F, A and S. It is a sensitive test for assessing frontal lobe functions.ObjectiveTo provide normative data for the elderly Brazilian population on the FAS test and to investigate the effects of age and schooling on test performance.MethodsThe individuals were divided into three age groups (60–69, 70–79 and =80 years), and into four groups according to education (1–3, 4–7, 8–11 and 12 years). All subjects were assessed by the Mini Mental State Examination and the FAS. Data were analyzed with Student’s t test, ANOVA, simple linear regression and Spearman’s correlation.ResultsWe evaluated 345 cognitively healthy volunteers, 66.66% being female, aged 60 to 93 years, with an educational level ranging from one to 24 years. The average (number of items) ±SD for the whole sample was 28.28±11.53. No significant effect of gender was observed (p=0.5). Performance on the MMSE and education exerted a direct influence on FAS scores (p<0.001), with education being the most significant factor. A positive correlation was found between FAS and the MMSE (r=0.404; p<0.001).ConclusionThe performance of Brazilian elderly on the phonemic verbal fluency tests-FAS is significantly influenced by education, where individuals with higher educational level present better performance than those with fewer years of schooling. Age and gender did not prove significant with the FAS.

Cognitive decline, particularly executive dysfunction, is observed in normal aging. In Brazil, the elderly population presents broad educational diversity. Category verbal fluency tests are frequently used to detect cognitive impairment, assessing executive function, language and semantic memory.ObjectiveTo investigate the effects of age and education on category animal fluency task (CAF) in healthy elderly.MethodsWe evaluated 319 healthy elderly from outpatient care units of two university reference centers of Rio de Janeiro and São Paulo. The sample was divided into two age, and five schooling subgroups. To be included participants had to demonstrate preservation of global cognitive functioning, independence for activities of daily living and not fulfill diagnostic criteria for dementia. All participants were submitted to neurological and neuropsychological evaluations.ResultsThere was a correlation between age and CAF performance (r= –0.26, p<0.01), which was not confirmed when years of education were included as a covariant in univariate ANCOVA. Significant differences were found in CAF performance among the different educational level groups on correlation analysis (r=0.42, p<0.01) and ANCOVA analysis (F=18.8, p<0.05). Illiteracy was associated with worst CAF performance, while university level was associated with best performance.ConclusionThe best CAF performance was found in the first years of schooling (literacy learning process) compared to illiteracy, and when finishing high school and starting university courses compared to all other educational levels. These stages are associated with significant gains in semantic memory and executive function which are critical for verbal fluency performance.

We would like to congratulate Aprahamian et al. (2011) for their initiative to investigate the psychometric properties of the Cambridge Cognition Examination (CAMCOG) in assessing the cognitive status of the Brazilian elderly. This instrument is very frequently used in Brazil, but its measure characteristics have not yet been fully determined. Of course, cross-cultural adaptation and validation are rarely a simple procedure, often demanding a research program to completely adapt the tool to the specific language, culture, and selected population. In our opinion, the paper “Can the CAMCOG be a good cognitive test for patients with Alzheimer's disease with low levels of education?” (Aprahamian et al., 2011) is welcome as another trial by Brazilian scientists in this ongoing process. Notwithstanding, we believe that some comments about the methodological aspects of the paper are in order.