A Comparison Between the Performances of Verbal and Nonverbal Fluency Tests in Discriminating Between Mild Cognitive Impairments and Alzheimer's Disease Patients and Their Brain Morphological Correlates

Dement Neurocogn Disord. 2022 Jan;21(1):17-29. doi: 10.12779/dnd.2022.21.1.17. Epub 2022 Jan 7.

Abstract

Background and purpose: Verbal and nonverbal fluency tests are the conventional methods for examining executive function in the elderly population. However, differences in impairments result in fluency tests in patients with mild cognitive impairments (MCIs) and Alzheimer's disease (AD) and in neural correlates underlying the tests still necessitate concrete evidence.

Methods: We compared the test performances in 27 normal controls, 28 patients with MCI, and 20 with AD, and investigated morphological changes in association with the test performances using structural magnetic imaging.

Results: Patients with AD performed poorly across all the fluency tests, and a receiver operating characteristics curve analysis revealed that only category fluency test discriminated all the 3 groups. Association, category, and design fluency tests involved temporal and frontal regions, while letter fluency involved the cerebellum and caudate.

Conclusions: Category fluency is a reliable measure for screening patients with AD and MCI, and this efficacy might be related to morphological correlates that underlie semantic and executive processing.

Keywords: Alzheimer’s Disease; Executive Function; Gray Matter; Language; Mild Cognitive Impairment; Neuropsychological Tests.