Analysis of brief language tests in the detection of cognitive decline and dementia

To study category verbal fluency (VF) for animals in patients with amnestic mild cognitive impairment (aMCI), mild Alzheimer disease (AD) and normal controls.MethodFifteen mild AD, 15 aMCI, and 15 normal control subjects were included. Diagnosis of AD was based on DSM-IV and NINCDS-ADRDA criteria, while aMCI was based on the criteria of the International Working Group on Mild Cognitive Impairment, using CDR 0.5 for aMCI and CDR 1 for mild AD. All subjects underwent testing of category VF for animals, lexical semantic function (Boston Naming-BNT, CAMCOG Similarities item), WAIS-R forward and backward digit span, Rey Auditory Verbal Learning (RAVLT), Mini-Mental Status Examination (MMSE), and other task relevant functions such as visual perception, attention, and mood state (with Cornell Scale for Depression in Dementia). Data analysis used ANOVA and a post-hoc Tukey test for intergroup comparisons, and Pearson’s coefficient for correlations of memory and FV tests with other task relevant functions (statistical significance level was p<0.05).ResultsaMCI patients had lower performance than controls on category VF for animals and on the backward digit span subtest of WAIS-R but higher scores compared with mild AD patients. Mild AD patients scored significantly worse than aMCI and controls across all tests.ConclusionaMCI patients may have poor performance in some non-memory tests, specifically category VF for animals in our study, where this could be attributable to the influence of working memory.

Section: Discussionmentioning

confidence: 83%

Category verbal fluency performance may be impaired in amnestic mild cognitive impairment

Balthazar¹,

Cendes²,

Damasceno

2007

“… 24 The participants in this study had high levels of schooling, which showed the importance of education in the preservation of cognitive functions objectively assessed in the CAMCOG evaluation. 25 High scores on the CAMCOG were reported by Aprahamian et al 26 whose study found new cut-off points on the CAMCOG test according to education. In subjects with a high level of education (=9 years) the cut-off point should be 90 points.…”

Section: Discussionmentioning

confidence: 89%

Verbal behavior in Alzheimer disease patients: Analysis of phrase repetition

Cecato

Martinellil

Bartholomeu

et al. 2010

Language problems in the elderly with AD are due to the fact that deterioration occurs not only in semantic memory, but in a group of cognitive factors, evidenced by a deficiency in search strategies for linguistic information.ObjectivesTo evaluate phrase repetition in two cognitive tests, the MMSE and MoCA, in a group of Alzheimer disease patients (AD) and normal controls.MethodsA Cross-sectional study was conducted involving 20 patients who sought medical assistance at a geriatric institute in Jundiaí, São Paulo. The subjects underwent a detailed clinical examination and neuropsychometric evaluation. All subjects with AD met DSM-IV and NINCDS-ADRDA criteria. Ten patients received a diagnosis of AD and 10 were healthy subjects, forming the control group (CG).ResultsAll participants correctly answered the phrase from the MMSE (phrase 1). The MoCA phrases (phrases 2 and 3) were correct in 80% and 90%, respectively in the CG and in 40% and 50%, respectively in the AD group.ConclusionsThe MoCA test proved more effective in evaluating the echoic behavior in AD patients compared to the MMSE. The simpler phrase repetition task in the MMSE was found to be less sensitive in detecting mild language decline in AD patients.

“…Category verbal fluency 9 (CVF) is a very useful and sensitive test for cognitive deterioration, 10 - 16 assessing executive functions (mental organization, strategies for search), semantic and working memory, speed processing and language (size of vocabulary). 17 , 18 …”

mentioning

confidence: 99%

Age and educational level effects on the performance of normal elderly on category verbal fluency tasks

Fichman

Fernandes

Nitrini

et al. 2009

Self Cite

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.