Episodic Memory and Verbal Fluency Tasks: Normative Data from Nine Nationally Representative Samples

J Int Neuropsychol Soc. 2021 Jan;27(1):89-98. doi: 10.1017/S1355617720000582. Epub 2020 Aug 7.


Objective: This study aims to generate country-specific norms for two episodic memory tasks and a verbal fluency test among middle-aged and older adults using nationally representative data from nine low-, middle-, and high-income countries.

Method: Data from nine countries in Africa, Asia, Europe, and Latin America were analyzed (n = 42,116; aged 50 years or older). Episodic memory was assessed with the word list memory (three trials of immediate recall) and word list recall (delayed recall). Verbal fluency was measured through the animal naming task. Multiple linear regression models with country-specific adjustments for gender, age, education, and residential area were carried out.

Results: Both age and education showed high influence on test performance (i.e. lower cognitive performance with increasing age and decreasing years of education, respectively), while the effect of sex and residential area on cognitive function was neither homogeneous across countries nor across cognitive tasks.

Conclusions: Our study provided sex-, age-, education-, and residential area-specific regression-based norms that were obtained from one of the largest normative study worldwide on verbal recall and fluency tests to date. Findings derived from this study will be especially useful for clinicians and researchers based at countries where cognitive norms are limited.

Keywords: Assessment; Cognition; Elderly/Aging; Neuropsychology; Norms/Normative studies; Population-based study.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cognition
  • Educational Status
  • Humans
  • Memory, Episodic*
  • Mental Recall
  • Middle Aged
  • Neuropsychological Tests