The Role of Verb Fluency in the Detection of Early Cognitive Impairment in Alzheimer's Disease

J Alzheimers Dis. 2018;62(2):611-619. doi: 10.3233/JAD-170826.


Background: Verb fluency (VF) is the less commonly used fluency test, despite several studies suggesting its potential as a neuropsychological assessment tool.

Objective: To investigate the presence of VF deficits in mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) dementia; to assess the usefulness of VF in the detection of cognitively healthy (CH) people who will convert to MCI, and from MCI to dementia; and to establish the VF cut-offs useful in the cognitive assessment of Spanish population.

Methods: 568 CH, 885 MCI, and 367 mild AD dementia individuals were administered the VF test and a complete neuropsychological battery. Longitudinal analyses were performed in 231 CH and 667 MCI subjects to search for VF predictors of diagnosis conversion.

Results: A worsening on VF performance from CH, MCI to AD dementia groups was found. Lower performances on VF were significantly related to conversion from CH to MCI/MCI to dementia. When the effect of time to conversion was analyzed, a significant effect of VF was found on the faster conversion from CH to MCI, but not from MCI to dementia. Moreover, VF cut-off scores and sensitivity/specificity values were calculated for 6 conditions (3 age ranges by 2 educational levels).

Conclusion: The VF test may be a useful tool for the differential diagnosis of cognitive failure in the elderly. Since VF deficits seem to take place in early stages of the disease, it is a suitable neuropsychological tool for the detection not only of CH people who will convert to MCI, but also from MCI to dementia.

Keywords: Alzheimer’s disease; cognitively healthy; mild cognitive impairment; verb fluency; verbal fluency.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis*
  • Case-Control Studies
  • Cognitive Dysfunction / diagnosis*
  • Cross-Sectional Studies
  • Early Diagnosis
  • Executive Function
  • Female
  • Humans
  • Language Tests*
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Sensitivity and Specificity
  • Spain