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American Journal of Alzheimer's Disease and Other Dementias logoLink to American Journal of Alzheimer's Disease and Other Dementias
. 2009 Dec;24(6):461–468. doi: 10.1177/1533317509345154

Longitudinal Verbal Fluency in Normal Aging, Preclinical, and Prevalent Alzheimer’s Disease

Linda J Clark 1, Margaret Gatz 2, Ling Zheng, Yu-Ling Chen 3, Carol McCleary 4, Wendy J Mack 5
PMCID: PMC2824246  NIHMSID: NIHMS176809  PMID: 19759254

Abstract

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’s 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.

Keywords: dementia, neuropsychology, fluency, Alzheimer’s disease, semantic memory, cognitive impairment

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Contributor Information

Linda J. Clark, Alzheimer Disease Research Center, and Department of Neurology, University of Southern California, Los Angeles, California.

Margaret Gatz, Department of Psychology, University of Southern California, Los Angeles, California.

Yu-Ling Chen, Alzheimer Disease Research Center, and Department of Neurology, University of Southern California, Los Angeles, California.

Carol McCleary, Alzheimer Disease Research Center, and Department of Neurology, University of Southern California, Los Angeles, California.

Wendy J. Mack, Department of Preventive Medicine, University of Southern California, Los Angeles, California, wmack@usc.edu .

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