Semantic Verbal Fluency: Normative Data in Older Spanish Adults From NEDICES Population-Based Cohort

  1. Contador, Israel 1
  2. Almondes, Katie 2
  3. Fernández-Calvo, Bernardino 3
  4. Boycheva, Elina 4
  5. Puertas-Martín, Verónica 5
  6. Benito-León, Julián 456
  7. Bermejo-Pareja, Félix 467
  1. 1 Department of Basic Psychology, Psychobiology and Methodology of Behavioral Science, University of Salamanca, Salamanca, Spain
  2. 2 Universidade Federal do Rio Grande do Norte

    Universidade Federal do Rio Grande do Norte

    Natal, Brasil


  3. 3 Universidade Federal da Paraíba

    Universidade Federal da Paraíba

    João Pessoa, Brasil


  4. 4 Instituto de Investigación Sanitaria Hospital 12 de Octubre

    Instituto de Investigación Sanitaria Hospital 12 de Octubre

    Madrid, España

  5. 5 Hospital Universitario 12 de Octubre

    Hospital Universitario 12 de Octubre

    Madrid, España


  6. 6 Instituto de Salud Carlos III

    Instituto de Salud Carlos III

    Madrid, España


  7. 7 Universidad Complutense de Madrid

    Universidad Complutense de Madrid

    Madrid, España

    ROR 02p0gd045

Archives of Clinical Neuropsychology

ISSN: 0887-6177 1873-5843

Year of publication: 2016

Type: Article

DOI: 10.1093/ARCLIN/ACW071 WoS: WOS:000392974600012 GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Archives of Clinical Neuropsychology


Objective: We aimed to provide the normative data stratified by age, sex and educational attainment for two semantic categories (animal and fruits) in older Spanish adults.Method: A representative sample of 2,744 non-demented older individuals with different socioeconomic background was selected from the Neurological Disorders in Central Spain (NEDICES), a population-based study. Normative data are presented in percentile ranks and divided into four age-tables with different midpoints, using the overlapping interval procedure.Results: Correlation analyses showed that age, education and sex influence significantly the scores in both semantic tasks. Normative data presented here covered two urban (Margaritas & Lista) and one rural areas (Arevalo).Conclusion: These norms may provide useful data for screening cognitive impairment more accurately in Spanish older adults.

Bibliographic References

  • Alegret, M., Espinosa, A., Valero, S., Vinyes-Junqué, G., Ruiz, A., Hernández, I., et al. . (2013). Cut-off scores of a brief neuropsychological battery (NBACE) for Spanish individual adults older than 44 years old. PloS One, 8 (10), e76436.
  • Alladi, S., Arnold, R., Mitchell, J., Nestor, P. J., & Hodges, J. R. (2006). Mild cognitive impairment: applicability of research criteria in a memory clinic and characterization of cognitive profile. Psychological Medicine, 36 (4), 507–515.
  • Amaducci, L., Baldereschi, M., Amato, M. P., Lippi, A., Nencini, P., Maggi, S., et al. . (1991). The World Health Organization cross-national research program on age-associated dementias. Aging (Milan, Italy), 3 (1), 89–96.
  • Ardila, A., Bertolucci, P. H., Braga, L. W., Castro-Caldas, A., Judd, T., Kosmidis, M. H., et al. . (2010). Illiteracy: the neuropsychology of cognition without reading. Archives of Clinical Neuropsychology, 25 (8), 689–712. Azuma, T. (2004). Working memory and perseveration in verbal fluency. Neuropsychology, 18 (1), 69–77.
  • Baldereschi, M., Amato, M. P., Nencini, P., Pracucci, G., Lippi, A., Amaducci, L., et al. . (1994). Cross-national interrater agreement on the clinical diagnostic criteria for dementia. WHO-PRA Age-Associated Dementia Working Group, WHO-Program for Research on Aging, Health of Elderly Program. Neurology, 44 (2), 239–242.
  • Benito-Cuadrado, M. M., Esteba-Castillo, S., Böhm, P., Cejudo-Bolívar, J., & Peña-Casanova, J. (2002). Semantic verbal fluency of animals: a normative and predictive study in a Spanish population. Journal of Clinical and Experimental Neuropsychology, 24 (8), 1117–1122.
  • Bermejo-Pareja, F., Benito-León, J., Vega-Q, S., Díaz-Guzmán, J., Rivera-Navarro, J., Molina, J. A., et al. . (2008a). The NEDICES cohort of the elderly. Methodology and main neurological findings. Revista De Neurologia, 46 (7), 416–423.
  • Bermejo-Pareja, F., Benito-León, J., Vega, S., Medrano, M. J., & Román, G. C., Neurological Disorders in Central Spain (NEDICES) Study Group (2008b). Incidence and subtypes of dementia in three elderly populations of central Spain. Journal of the Neurological Sciences, 264 (1–2), 63–72.
  • Buriel, Y., Gramunt, N., Bohm, P., Rodes, E., & Pena-Casanova, J. (2004). Verbal fluency: preliminary normative data in a Spanish sample of young adults (20–49 years of age). Neurología (Barcelona, Spain), 19 (4), 153–159.
  • Busch, R. M., & Chapin, J. S. (2008). Review of normative data for common screening measures used to evaluate cognitive functioning in elderly individuals. The Clinical Neuropsychologist, 22 (4), 620–650.
  • Capitani, E., Laiacona, M., & Barbarotto, R. (1999). Gender affects word retrieval of certain categories in semantic fluency tasks. Cortex, 35, 273–278.
  • Casals-Coll, M., Sánchez-Benavides, G., Quintana, M., Manero, R. M., Rognoni, T., Calvo, L., et al. . (2013). Spanish normative studies in young adults (NEURONORMA young adults project): norms for verbal fluency tests. Neurología (Barcelona, Spain), 28 (1), 33–40.
  • Chávez-Oliveros, M., Rodríguez-Agudelo, Y., Acosta-Castillo, I., García-Ramírez, N., Rojas de la Torre, G., & Sosa-Ortiz, A. L. (2015). Semantic verbal fluency in elderly Mexican adults: reference values. Neurología (Barcelona, Spain), 30 (4), 189–194.
  • Contador, I., Bermejo-Pareja, F., Del Ser, T., & Benito-León, J. (2015). Effects of education and word reading on cognitive scores in a community-based sample of Spanish elders with diverse socioeconomic status. Journal of Clinical and Experimental Neuropsychology, 37 (1), 92–101.
  • Contador, I., Bermejo-Pareja, F., Fernández-Calvo, B., Boycheva, E., Tapias, E., Llamas, S., et al. . (2016a). The 37 item Version of the Mini-Mental State Examination: normative data in a population-based cohort of older Spanish Adults (NEDICES). Archives of Clinical Neuropsychology, 31, 263–272. Contador, I., Del Ser, T., LLamas, S., Villarejo, A., Benito-León, J., & Bermejo-Pareja, F. (2016b). Impact of literacy and years of education on the diagnosis of dementia: a population-based study. Journal of Clinical & Experimental Neuropsychology, in press.
  • Contador, I., Fernández-Calvo, B., Ramos, F., Tapias-Merino, E., & Bermejo-Pareja, F. (2010). Dementia screening in primary care: critical review. Revista De Neurologia, 51 (11), 677–686.
  • Contador, I., & Ramos, F. (2009). La Neuropsicología en la Enfermedad de Alzheimer. In I. Contador Castillo, & E. Cuacos de Yuste(Eds.), La enfermedad de Alzheimer: desde la neuropsicología a la intervención psicosocial. (pp. 53–82) Cuacos de Yuste, Cáceres: Fundación Academia Europea de Yuste.
  • de Paula, J. J., Bertola, L., Ávila, R. T., Moreira, L., Coutinho, G., de Moraes, E. N., et al. . (2013). Clinical applicability and cutoff values for an unstructured neuropsychological assessment protocol for older adults with low formal education. PloS One, 8 (9), e73167.
  • Ganguli, M., Snitz, B. E., Lee, C.-W., Vanderbilt, J., Saxton, J. A., & Chang, C.-C. H. (2010). Age and education effects and norms on a cognitive test battery from a population-based cohort: The Monongahela –Youghiogheny Healthy Aging Team (MYHAT). Aging & Mental Health, 14 (1), 100–107.
  • Glisky, E. L. (2007). Changes in cognitive function in human aging. In R. D. Riddle (Ed.), Brain aging: models, methods, mechanisms (pp.1–15). Boca Raton (FL): CRC Press.
  • González, H. M., Mungas, D., & Haan, M. N. (2005). A semantic verbal fluency test for English- and Spanish-speaking older Mexican-Americans. Archives of Clinical Neuropsychology: The Official Journal of the National Academy of Neuropsychologists, 20 (2), 199–208.
  • Gourovitch, M. L., Kirkby, B. S., Goldberg, T. E., Weinberger, D. R., Gold, J. M., Esposito, G., et al. . (2000). A comparison of rCBF patterns during letter and semantic fluency. Neuropsychology, 14 (3), 353–360.
  • Heaton, R. K., Ryan, L., & Grant, I. (2009). Demographic influences and use of demographically corrected norms in neuropsychologial assessment. In: I. Grant, & K. M. Adams (Eds.). Neuropsychological Assessment of Neuropsychiatric Disorders (pp. 127-155). New York: Oxford University Press.
  • Henry, J. D., & Crawford, J. R. (2004). Verbal fluency deficits in Parkinson's disease: a meta-analysis. Journal of the International Neuropsychological Society: JINS, 10 (4), 608–622.
  • Howieson, D. B., & Lezak, M. D. (2010). The neuropsychological evaluation. In S. C. Yudofsky, & R. E. Hales (Eds.), Essentials of Neuropsychiatry and Behavioral Neurosciences (pp. 29–54). Arlington, VA: American Psychiatric Publishing.
  • Isaacs, B., & Kennie, A. T. (1973). The Set test as an aid to the detection of dementia in old people. The British Journal of Psychiatry: The Journal of Mental Science, 123 (575), 467–470.
  • Laukka, E. J., Macdonald, S. W. S., Fratiglioni, L., & Bäckman, L. (2012). Preclinical cognitive trajectories differ for Alzheimer's disease and vascular dementia. Journal of the International Neuropsychological Society: JINS, 18 (2), 191–199.
  • Lavoie, M., Callahan, B., Belleville, S., Simard, M., Bier, N., Gagnon, L., et al. . (2013). Normative data for the Dementia Rating Scale-2 in the French-Quebec population. The Clinical Neuropsychologist, 27 (7), 1150–1166.
  • Lozano, A., & Ostrosky-Solis, F. (2006). Effect of age and level of education on semantic fluency: normative data for Spanish-speaking population. Revista Mexicana de Psicología, 23 (1), 37–44.
  • Marcopulos, B. A., Gripshover, D. L., Broshek, D. K., McLain, C. A., & Brashear, H. R. (1999). Neuropsychological assesment of psychogeriatric patients with limited education. The Clinical Neuropsychologist, 13 (2), 147–156.
  • Mitrushina, M. N., Boone, K. B., Razani, L. J., & D'Elia, L. F. (Ed.). (2005). Handbook of normative data for neuropsychological assessment (2nd ed.). New York: Oxford University Press. Monsch, A. U., Bondi, M. W., Butters, N., Salmon, D. P., Katzman, R., & Thal, L. J. (1992). Comparisons of verbal fluency tasks in the detection of dementia of the Alzheimer type. Archives of Neurology, 49 (12), 1253–1258. Morales, J. M., Bermejo, F. P., Benito-León, J., Rivera-Navarro, J., Trincado, R., Gabriel, S. R., et al. NEDICES Study Group (2004). Methods and demographic findings of the baseline survey of the NEDICES cohort: a door-to-door survey of neurological disorders in three communities from Central Spain. Public Health, 118 (6), 426–433.
  • Mueller, K. D., Koscik, R. L., LaRue, A., Clark, L. R., Hermann, B., Johnson, S. C., et al. . (2015). Verbal fluency and early memory decline: results from the Wisconsin registry for Alzheimer's Prevention. Archives of Clinical Neuropsychology: The Official Journal of the National Academy of Neuropsychologists, 30 (5), 448–457.
  • O'Connell, M. E., & Tuokko, H. (2010). Age corrections and dementia classification accuracy. Archives of Clinical Neuropsychology: The Official Journal of the National Academy of Neuropsychologists, 25 (2), 126–138.
  • Olabarrieta-Landa, L., Rivera, D., Galarza-Del-Angel, J., Garza, M. T., Saracho, C. P., Rodríguez, W., et al. . (2015). Verbal fluency tests: Normative data for the Latin American Spanish speaking adult population. NeuroRehabilitation, 37 (4), 515–561.
  • Olazarán, J., Mouronte, P., & Bermejo, F. (2005). Clinical validity of two scales of instrumental activities in Alzheimer's disease. Neurología (Barcelona, Spain), 20 (8), 395–401.
  • Ostrosky-Solis, F., Gutierrez, A. L., Flores, M. R., & Ardila, A. (2007). Same or different? Semantic verbal fluency across Spanish-speakers from different countries. Archives of Clinical Neuropsychology: The Official Journal of the National Academy of Neuropsychologists, 22 (3), 367–377.
  • Pauker, J. D. (1988). Constructing overlapping cell tables to maximize the clinical usefulness of normative test data: rationale and an example from neuropsychology. Journal of Clinical Psychology, 44 (6), 930–933.
  • Peña-Casanova, J., Quiñones-Ubeda, S., Gramunt-Fombuena, N., Quintana-Aparicio, M., Aguilar, M., Badenes, D., et al. NEURONORMA Study Team (2009). Spanish Multicenter Normative Studies (NEURONORMA Project): norms for verbal fluency tests. Archives of Clinical Neuropsychology: The Official Journal of the National Academy of Neuropsychologists, 24 (4), 395–411.
  • Prieto, G., Contador, I., Tapias-Merino, E., Mitchell, A. J., & Bermejo-Pareja, F. (2012). The Mini-Mental-37 test for dementia screening in the Spanish population: an analysis using the Rasch Model. The Clinical Neuropsychologist, 26 (6), 1003–1018.
  • Rende, B., Ramsberger, G., & Miyake, A. (2002). Commonalities and differences in the working memory components underlying letter and category fluency tasks: a dual-task investigation. Neuropsychology, 16 (3), 309–321.
  • Ruff, R. M., Light, R. H., Parker, S. B., & Levin, H. S. (1997). The psychological construct of word fluency. Brain and Language, 57 (3), 394–405. Schmid, N. S., Taylor, K. I., Foldi, N. S., Berres, M., & Monsch, A. U. (2013). Neuropsychological signs of Alzheimer's disease 8 years prior to diagnosis. Journal of Alzheimer's Disease: JAD, 34 (2), 537–546.
  • Serna, A., Contador, I., Bermejo-Pareja, F., Mitchell, A. J., Fernández-Calvo, B., Ramos, F., et al. . (2015). Accuracy of a brief neuropsychological battery for the diagnosis of dementia and mild cognitive impairment: an analysis of the NEDICES cohort. Journal of Alzheimer's Disease: JAD, 48 (1), 163–173.
  • Shao, Z., Janse, E., Visser, K., & Meyer, A. S. (2014). What do verbal fluency tasks measure? Predictors of verbal fluency performance in older adults. Frontiers in Psychology, 5, 772.
  • Tola-Arribas, M. A., Garea, M. J., Yugueros, M. I., Ortega-Valín, F., Cerón, A., Fernández-Malvido, B., et al. DEMINVALL study group (2012). Design, methods and demographic findings of the DEMINVALL survey: a population-based study of Dementia in Valladolid, Northwestern Spain. BMC Neurology, 12, 86.