Demographically-adjusted norms for selected tests of verbal fluency: Results from the Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) project

Marquine, María J.; Paredes, Alejandra Morlett; Madriaga, Cecilia; Blumstein, Y; Umlauf, Anya; Kamalyan, Lily; Mindt, Monica Rivera; Suárez, Paola; Fortuni, Lidia Artiola I; Heaton, Robert K.; Cherner, Mariana

doi:10.1080/13854046.2020.1762931

Cited by 34 publications

(22 citation statements)

References 85 publications

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“…Second, VF are tasks language-dependent, and our results should be confirmed in other cultures. In this regard, there are differences in the frequency of words between languages, and cross-cultural adaptations are required to minimize it, especially for phonemic fluency (27,28). For instance, words beginning with "f, " "a, " and "s" are common phonemic fluency tasks for English speakers, but for Spanish speakers the initial letters "p, " "m, " and "r" have been proposed as an alternative and are generally preferred, based on the frequency of words (27)(28)(29).…”

Section: Discussionmentioning

confidence: 99%

Cognitive Processes Underlying Verbal Fluency in Multiple Sclerosis

et al. 2021

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Background: Verbal fluency (VF) has been associated with several cognitive functions, but the cognitive processes underlying verbal fluency deficits in Multiple Sclerosis (MS) are controversial. Further knowledge about VF could be useful in clinical practice, because these tasks are brief, applicable, and reliable in MS patients. In this study, we aimed to evaluate the cognitive processes related to VF and to develop machine-learning algorithms to predict those patients with cognitive deficits using only VF-derived scores.Methods: Two hundred participants with MS were enrolled and examined using a comprehensive neuropsychological battery, including semantic and phonemic fluencies. Automatic linear modeling was used to identify the neuropsychological test predictors of VF scores. Furthermore, machine-learning algorithms (support vector machines, random forest) were developed to predict those patients with cognitive deficits using only VF-derived scores.Results: Neuropsychological tests associated with attention-executive functioning, memory, and language were the main predictors of the different fluency scores. However, the importance of memory was greater in semantic fluency and clustering scores, and executive functioning in phonemic fluency and switching. Machine learning algorithms predicted general cognitive impairment and executive dysfunction, with F1-scores over 67–71%.Conclusions: VF was influenced by many other cognitive processes, mainly including attention-executive functioning, episodic memory, and language. Semantic fluency and clustering were more explained by memory function, while phonemic fluency and switching were more related to executive functioning. Our study supports that the multiple cognitive components underlying VF tasks in MS could serve for screening purposes and the detection of executive dysfunction.

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Section: Discussionmentioning

confidence: 99%

Cognitive Processes Underlying Verbal Fluency in Multiple Sclerosis

et al. 2021

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“…Raw test scores were converted into demographically adjusted T-scores (adjusted for age, sex, and education level) for each test. Norms for native Spanish speakers from the Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) were applied to all tests when available, including for semantic/category fluency (Animal Naming) (38), letter fluency (PMR) (38), HVLT-R Total Learning and Delayed Recall (39), and Grooved Pegboard (dominant and nondominant hand) (40). English-speaking norms with similar mean educational levels to that of our study were utilized for those tests for which there were no demographically adjusted Spanish NP-NUMBRS norms available given there are no Spanishspeaker norms for a Peruvian population that were adequate for our population.…”

Section: Neuropsychological Test Batterymentioning

confidence: 99%

Characterization of HIV-Associated Neurocognitive Impairment in Middle-Aged and Older Persons With HIV in Lima, Peru

et al. 2021

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Background: With widespread use of antiretroviral medications, people living with HIV (PWH) are living longer worldwide, increasing their risk of developing neurocognitive impairment (NCI). The proportion of Peruvians over age 60 is expected to increase to 25% of the population by 2050, including PWH. Therefore, the problem of aging and NCI, especially in the setting of HIV infection, is uniquely pressing. We sought to study the rates of and risk factors associated with NCI among middle-aged and older PWH in Lima, Peru.Materials and Methods: Sociodemographic, medical (infectious and non-infectious), and psychiatric comorbidity and laboratory data were collected. We administered a brief neuropsychological battery evaluating seven cognitive domains affected in HIV-associated NCI and a depression screening. Cognitive test raw scores were converted to T-scores that were demographically adjusted. Descriptive statistics were performed together with regression (unadjusted and adjusted) analyses to determine potential risk factors for NCI among PWH.Results: This was a cross-sectional study in which 144 PWH aged ≥40 years attending a large HIV clinic in Lima, Peru, were recruited from September 2019 to March 2020. Mean age was 51.6 ± 7.7 years, and mean years of education were 14.0 ± 3.1 with 15% females. Median [interquartile range (IQR)] current CD4 and nadir CD4 were 554 (371, 723) and 179 (83, 291), respectively, and 10% currently had AIDS. The prevalence of NCI was 28.5%, and many demonstrated difficulty with attention and working memory (70%). One-quarter of PWH had mild depression or worse on Patient Health Questionnaire 9 (PHQ-9 ≥ 5). In bivariate analyses, neither a depression history nor a higher PHQ-9 score correlated with NCI. No other non-communicable medical or psychiatric comorbidity nor HIV characteristic was predictive of NCI. Having a positive lifetime history of hepatitis B infection, pulmonary tuberculosis, or syphilis increased risk of NCI (PR 1.72; 95% CI 1.04–2.86) in unadjusted analyses, but not in adjusted analyses.Conclusions: NCI among older Peruvians with HIV was found to be highly prevalent with levels consistent with prior reports of HIV-associated NCI worldwide. Common latent HIV-associated co-infections, including latent syphilis, hepatitis B infection, or pulmonary tuberculosis, may increase the risk of NCI among middle-aged and older PWH in Peru.

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“…These normative data complement a larger comprehensive neuropsychological battery assessing different cognitive domains [ 12 , 13 ]. As in previous works [ 35 , 36 , 50 , 69 , 70 ], quadratic age and education was included in the regression models to explore possible non-linear associations between these variables and performance in the tests.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the Phonetic Verbal Fluency test (PVF) is used as a measure of executive function while the Semantic Verbal Fluency test (SVF) is usually used as a measure of semantic memory. Some studies provided normative data for this test in Spain [ 34 ] and Latin America [ 35 , 36 , 37 , 38 ] with adults from the general population.…”

Section: Introductionmentioning

confidence: 99%

Regression-Based Normative Data for Independent and Cognitively Active Spanish Older Adults: Verbal Fluency Tests and Boston Naming Test

Iñesta

Oltra-Cucarella

Maciá

2022

IJERPH

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An increased cognitive reserve is associated with changes in the pattern of cognitive decline during aging. Thus, normative data adapted to the characteristics of the target population are needed to reduce the possibility of false diagnoses. The aim of this work was to develop normative data for the Phonemic Verbal Fluency test, the Semantic Verbal Fluency test and the Boston Naming Test (BNT). Method: Regression-based normative data were calculated from a sample of 118 non-depressed, cognitively active, independent community-dwelling adults aged 55 or older (64.4% women) from SABIEX (University for Seniors at the Universidad Miguel Hernández de Elche). Raw scores were regressed on age, sex, and education. Results: The effects of age and education varied across neuropsychological measures. No effect of sex was found in any of the tests assessed. Statistically significant differences were found in the proportion of low scores using SABIEX or population-based normative datasets. The level of agreement identifying individuals labeled as showing one or more low scores was only fair-to-good. Conclusions: Normative data obtained from the general population might not be sensitive to identify low scores in cognitively active older adults, increasing the risk of misdiagnoses. A friendly calculator is available for neuropsychological assessment.

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Demographically-adjusted norms for selected tests of verbal fluency: Results from the Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) project

Cited by 34 publications

References 85 publications

Cognitive Processes Underlying Verbal Fluency in Multiple Sclerosis

Cognitive Processes Underlying Verbal Fluency in Multiple Sclerosis

Characterization of HIV-Associated Neurocognitive Impairment in Middle-Aged and Older Persons With HIV in Lima, Peru

Regression-Based Normative Data for Independent and Cognitively Active Spanish Older Adults: Verbal Fluency Tests and Boston Naming Test

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