Verbal Fluency Tasks: Influence of Age, Gender, and Education and Normative Data for the Spanish Native Adult Population

Abstract

Objective: Phonological and semantic verbal fluency (VF) tasks are frequently used to assess language and executive functions in both clinical and research settings. F, A, and S are the most commonly used letters in phonological tasks across languages and cultures. Unfortunately, the lack of norms for the native Spanish population for these letters, and for certain semantic categories such as “proper names,” may lead to misinterpretation of scores due to demographic differences. The aim of the present study was to provide normative data for F, A, and S and for “proper names,” “animals,” and “fruits and vegetables” for the native Spanish population. Method: 257 healthy subjects took part in the study (ages: 17–100 years, 3–20 years of education). Correlation, multiple regression, and t-tests were used to select the most appropriate variables for stratification. Results: Education was the best predictor of performance in all tasks, followed by age. Given that t-test results showed no differences related to gender, with the only exception of the semantic category “animals,” this variable was not considered for stratification. Consequently, the data were stratified in two education levels (<13, ≥13 years of education) and in two age levels (<60, ≥60) within the low-educational level group. Mean, standard deviation, and percentile scores for each group are provided. Conclusions: The present norms provide a reference for clinicians assessing VF. This data may also facilitate comparisons with other normative studies in cross-cultural and cross-linguistic research.

Normative Data for Single-Letter Controlled Oral Word Association Test in Older White Australians and Americans, African-Americans, and Hispanic/Latinos

“…Over the past few decades, a range of studies have presented normative data for phonemic fluency in general populations, using trials with either single or triple letters [29,37,38,47,[50][51][52][53][54][55][56][57][58][59][60]. These studies have been conducted across various countries, including the U.S. [29,37,38], Canada [47,53], Brazil [52,55], Spain [56], France [58], Greece [54], Italy [51], Iceland [59], Ireland [60], and so forth [50,57,58]. However, most of these studies have recruited rela-tively small sample sizes, typically involving fewer than 500 individuals [38,[51][52][53][54][55][56][57]61].…”

“…These studies have been conducted across various countries, including the U.S. [29,37,38], Canada [47,53], Brazil [52,55], Spain [56], France [58], Greece [54], Italy [51], Iceland [59], Ireland [60], and so forth [50,57,58]. However, most of these studies have recruited rela-tively small sample sizes, typically involving fewer than 500 individuals [38,[51][52][53][54][55][56][57]61]. This limitation has potentially impeded the development of norms specific to different demographic groups.…”

“…This limitation has potentially impeded the development of norms specific to different demographic groups. Furthermore, most of these studies have focused on individuals with a wide age range (e.g., 16-95 years) [37,47,51,53,54,56,57,59] or specifically targeted younger populations (e.g., children and adolescents) [50,52,55]. As a result, the generalization of the conclusions from these studies to older adults may be limited.…”

Phonological fluency norms for Spanish middle-aged and older adults provided by the SCAND initiative (P, M, & R)

“…Some studies have found the different effects of age when comparing semantic fluency (SF) and PF (Santos Nogueira et al, 2016;Tombaugh et al, 1999), whereas others did not (Khalil, 2010;Loonstra et al, 2001). However, the impact of the educational level on the performance of VF tasks has been widely recognized in neuropsychological research (Lubrini et al, 2022;Peña-Casanova et al, 2009). It has been found that higher education levels are associated with the production of more words (Oberg & Ramírez, 2006).…”

“…Previous initiatives have provided norms for phonological fluency (PF) tests in different populations of Spanish-speaking natives from Spain: Peña-Casanova et al, (2009) for community-dwelling cognitively normal adults ( n = 346), ranging from 50 to 94 years of age, used the letters P, M, and R; Casals-Coll et al (2013) for a younger population, adults between 18 and 49 years old ( n = 179), used the letters P, M, and R; and Lubrini et al (2022) that assessed participants from 17 to 100 years old ( n = 257), utilized the letters F, A, and S. If we consider what has been mentioned before about the choice of reference normative data, it is evident that the studies carried out with a small sample (Casal-Coll et al, and Lubrini et al) would be the first to discard. Considering the date of publication, the work by Peña-Casanova et al, is 14 years old, so it could be considered outdated.…”