J Korean Neurol Assoc.
2016 Feb;34(1):14-22. 10.17340/jkna.2016.1.2.
The Difference of Verbal Fluency Task Performance between Alzheimer's Disease and Subcortical Vascular Dementia: CREDOS (Clinical Research Center for Dementia of South Korea) Study
- Affiliations
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- 1Dementia Centera, National Health Insurance Service Ilsan Hospital, Goyang, Korea. brainleejh@gmail.com
- 2Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
- 3Department of Neurology, Inha University School of Medicine, Incheon, Korea.
- 4Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
- 5Department of Neurology, Catholic Kwandong University International St. Mary's Hospital, Incheon, Korea.
- 6Department of Neurology, The Catholic University of Korea, College of Medicine, Bucheon St. Mary's Hospital, Bucheon, Korea.
- 7Department of Neurology, Bobath Memorial Hospital, Seongnam, Korea.
- KMID: 2153155
- DOI: http://doi.org/10.17340/jkna.2016.1.2
Abstract
- BACKGROUND
The verbal fluency test consists of two separate tests of semantic fluency and phonemic fluency. The performance patterns of these tests differ with the type of dementia. We studied the patterns of verbal fluency between Alzheimer's disease (AD) and subcortical vascular dementia (SVaD), and assessed the clinical utility of these tests.
METHODS
The 1,475 selected participants comprised 73 normal control subjects, 673 patients with amnestic mild cognitive impairment (aMCI), 535 AD patients, 42 patients with subcortical vascular mild cognitive impairment (svMCI), and 152 SVaD patients. We analyzed the z-score for the total number of animal items as a semantic fluency index and the z-score of the phonemic total score as a phonemic fluency index.
RESULTS
The performance of semantic fluency was lower than that of phonemic fluency in all groups. The SVaD group showed the worst scores and abnormal performances on both tests, while the AD group presented abnormal performance only for semantic fluency. Dividing the patients with dementia according to severity revealed a different pattern between AD and SVaD for the clinical dementia rating (CDR) stage of 0.5. The performance of the AD group declined gradually with CDR. However, the SVaD group performed very poorly in both tests even for very mild dementia (CDR stage of 0.5). The aMCI and svMCI groups exhibited similar performance patterns.
CONCLUSIONS
The pattern of semantic and phonemic fluency was not clinically useful at the MCI stage, but it could be helpful in differentiating AD and SVaD in the early stage of dementia.
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