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J Am Geriatr Soc. 2018 Apr;66(4):755-759. doi: 10.1111/jgs.15294. Epub 2018 Mar 23.

Semantic and Phonemic Verbal Fluency Discrepancy in Mild Cognitive Impairment: Potential Predictor of Progression to Alzheimer's Disease.

Author information

1
Mercer's Institute for Research on Ageing, St. James's Hospital, Dublin, Ireland.
2
The Irish Longitudinal Study on Ageing, Trinity College, Dublin, Ireland.

Abstract

OBJECTIVES:

To assess the utility of verbal fluency discrepancy scores in predicting progression to Alzheimer's disease (AD) in a cohort of individuals with mild cognitive impairment (MCI).

DESIGN:

Case control.

SETTING:

Cases identified from new referrals to a memory clinic and controls identified from The Irish Longitudinal Study on Ageing.

PARTICIPANTS:

Of 308 individuals with MCI at baseline identified from consecutive referrals to a memory clinic and compared at with age-, sex-, and education-matched controls (n=302), 161 completed 2 years of follow-up or progressed to AD during the study period.

MEASUREMENTS:

Verbal fluency discrepancy (semantic-phonemic fluency) scores at baseline were calculated for each participant. Each case was followed with repeated neuropsychological measurements, and multidisciplinary consensus diagnosis was recorded.

RESULTS:

Mean discrepancy score for those who progressed to AD (2.7) was significantly lower than for those who retained a MCI diagnosis (4.8) and normal controls (7.7) (p<.001). Logistic regression revealed that, for each unit decrease in discrepancy score at baseline, the odds of progressing to AD were 9% greater. (Exp(B) = 1.09, p=.02) CONCLUSION: Individuals with MCI have less of a semantic advantage than those without MCI. Those with MCI presenting with a phonemic advantage at initial assessment warrant close follow-up and a high index of suspicion for progression to AD.

KEYWORDS:

Alzheimer's disease; mild cognitive impairment; neuropsychological assessment; verbal fluency

PMID:
29572820
DOI:
10.1111/jgs.15294

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