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Longitudinal Verbal Fluency in Normal Aging, Preclinical, and Prevalent Alzheimer's Disease
Linda J. Clark, PhD,
Margaret Gatz, PhD,
Ling Zheng, PhD,
Yu-Ling Chen, MS,
Carol McCleary, PhD,
and
Wendy J. Mack, PhD*
* To whom correspondence should be addressed. E-mail: wmack{at}usc.edu.
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Abstract |
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Background: Few longitudinal studies evaluate differences in patterns of change of category compared to letter fluency across the spectrum of cognitive impairment. Methods: We compared change in category (animal and supermarket) and letter (F, A, S) fluency among 239 participants in 3 groups: remained cognitively normal throughout follow-up (n = 96), developed Alzheimer Disease (AD; preclinical AD, n = 21), and with AD at initial testing (prevalent AD, n = 122). Results: At baseline, prevalent and preclinical AD groups scored lower on animal than letter fluency. On all fluency measures, the prevalent AD declined faster than other groups (all P < .0001), and preclinical AD declined faster than unimpaired (all P  .02). Overall, animal fluency declined faster than letter fluency; animal fluency declined significantly faster than letter fluency among cognitively normal and prevalent AD participants. Conclusion: Greater longitudinal declines in category compared to letter fluency are consistent with cross-sectional studies. Steeper declines on both fluency measures distinguish preclinical AD from cognitively unimpaired individuals.
First published on September 16, 2009, doi:10.1177/1533317509345154
American Journal of Alzheimer's Disease and Other Dementias® 2009;24:461.
A more recent version of this article appeared on December 1, 2009
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