CoDAS
https://codas.org.br/article/doi/10.1590/2317-1782/20232021179en
CoDAS
Artigo Original

Clustering and switching analysis of verb fluency in individuals with Alzheimer’s disease

Análise de clustering e switching da fluência de verbos em indivíduos com doença de Alzheimer

Bárbara Costa Beber; Franceia Veiga Liedtke; Felipe Schroeder de Oliveira; Lucas Müller-Silveira; Emily Viega Alves; Márcia Lorena Fagundes Chaves; Jerusa Fumagalli de Salles

http://dx.doi.org/10.1590/2317-1782/20232021179en CoDAS, vol.35, n2, e20210179, 2023
PDF English
PDF Português
PDF
SciELO
Downloads: 0
Views: 525

Abstract

Purpose

To investigate verb fluency performance in individuals with Alzheimer’s disease compared with healthy older adults by analyzing total correct responses, number of clusters, average cluster size, and number of switches.

Methods

This is a case-control study of 39 healthy older adults and 29 older adults with a diagnosis of Alzheimer’s disease. Verb fluency performance was analyzed in terms of total number of correct verbs retrieved, number of clusters, average cluster size, and number of switches. To obtain the study outcomes, we previously conducted a procedure for categorization of the verbs that would compose the clusters. The classification of verbs was adapted for this study, including assessment by raters and analysis of inter-rater reliability.

Results

Individuals with Alzheimer’s disease showed significantly poorer performance than healthy controls in the number of switches and total number of correct verbs retrieved. The two groups did not differ significantly in the other measures.

Conclusion

In this study, individuals with Alzheimer’s disease showed impaired verb fluency, characterized by a reduced number of verbs retrieved and fewer transitions between verb categories. The findings suggest that, in Alzheimer’s disease, verb fluency is more sensitive to cognitive deficits resulting from executive dysfunction than from semantic disruption.

Keywords

Alzheimer’s Disease; Cognition; Language; Neuropsychology; Dementia

Resumo

Objetivo

Investigar o desempenho na tarefa de fluência de verbos de pessoas com doença de Alzheimer em comparação à idosos saudáveis, a partir da análise do número total de palavras corretas evocadas, do número de clusters, do tamanho médio dos clusters e do número de switches.

Método

Este é um estudo de caso-controle no qual participaram 39 idosos saudáveis e 29 participantes com diagnóstico de doença de Alzheimer. O desempenho da fluência de verbos dos participantes foi analisado quanto ao total de verbos gerados corretamente, número de clusters, tamanho médio dos clusters e número de switches. Para a obtenção dos desfechos do estudo foi realizado um processo prévio de definição das categorias de verbos que constituiriam clusters. A classificação dos verbos foi adaptada para a este estudo, incluindo a análise de juízes com investigação do índice de concordância.

Resultados

Dentre as variáveis de interesse comparadas entre os grupos estudados, houve um desempenho estatisticamente inferior no grupo de pessoas com doença de Alzheimer quanto ao número de switches e total de verbos gerados corretamente. Nas demais medidas, os grupos foram semelhantes.

Conclusão

Neste estudo pessoas com doença de Alzheimer apresentaram déficit no desempenho da tarefa de fluência verbal de verbos, caracterizado por uma redução do número total de verbos gerados e uma menor variabilidade de categorias de verbos. Os achados sugerem que, na doença de Alzheimer, a fluência de verbos é mais sensível aos déficits cognitivos decorrentes de disfunção executiva do que aos déficits semânticos.

Palavras-chave

Doença de Alzheimer; Cognição; Linguagem; Neuropsicologia; Demência

Referências

  1. Pekkala S. Verbal fluency tasks and the neuropsychology of language. In: Faust M, editor. The handbook of the neuropsychology of language. Chicester: Blackwell Publishing Ltd.; 2012. p. 619-34. http://dx.doi.org/10.1002/9781118432501.ch30
  2. Zimmermann N, Parente MAMP, Joanette Y, Fonseca RP. Unconstrained, phonemic and semantic verbal fluency: age and education effects, norms and discrepancies. Psicol Reflex Crit. 2014;27(1):55-63. http://dx.doi.org/10.1590/S0102-79722014000100007
  3. Beckenkamp CL, Becker N, Rodrigues JC, Salles JF. Estratégias de clustering e switching na evocação lexical de adultos após acidente vascular cerebral nos hemisférios direito e esquerdo. Av Psicol Latinoam. 2019;37(2):375-90. http://dx.doi.org/10.12804/revistas.urosario.edu.co/apl/a.6073
  4. Oh SJ, Sung JE, Choi SJ, Jeong JH. Clustering and switching patterns in semantic fluency and their relationship to working memory in mild cognitive impairment. Dement Neurocogn Disord. 2019;18(2):47-61. http://dx.doi.org/10.12779/dnd.2019.18.2.47 PMid:31297135.
  5. Simpson IC, Dumitrache CG, Calet N. Mental health symptoms and verbal fluency in elderly people: evidence from the Spanish longitudinal study of aging. Aging Ment Health. 2019;23(6):670-9. http://dx.doi.org/10.1080/13607863.2018.1448969 PMid:29634354.
  6. Tallberg IM, Ivachova E, Tinghag KJ, Östberg P. Swedish norms for word fluency tests: FAS, animals and verbs. Scand J Psychol. 2008;49(5):479-85. http://dx.doi.org/10.1111/j.1467-9450.2008.00653.x PMid:18452499.
  7. Beber BC, Chaves MLF. Does previous presentation of verbal fluency tasks affect verb fluency performance? Dement Neuropsychol. 2016;10(1):31-6. http://dx.doi.org/10.1590/s1980-57642016dn10100006 PMid:29213428.
  8. Piatt AL, Fields JA, Paolo AM, Tröster AI. Action (verb naming) fluency as an executive function measure: convergent and divergent evidence of validity. Neuropsychologia. 1999;37(13):1499-503. http://dx.doi.org/10.1016/S0028-3932(99)00066-4 PMid:10617270.
  9. Beber BC, Chaves MLF. The basis and applications of the action fluency and action naming tasks. Dement Neuropsychol. 2014;8(1):47-57. http://dx.doi.org/10.1590/S1980-57642014DN81000008 PMid:29213879.
  10. Haugrud N, Crossley M, Vrbancic M. Clustering and switching strategies during verbal fluency performance differentiate Alzheimer’s disease and healthy aging. J Int Neuropsychol Soc. 2011;17(6):1153-7. http://dx.doi.org/10.1017/S1355617711001196 PMid:22014065.
  11. Pakhomov SVS, Eberly LE, Knopman DS. Recurrent perseverations on semantic verbal fluency tasks as an early marker of cognitive impairment. J Clin Exp Neuropsychol. 2018;40(8):832-40. http://dx.doi.org/10.1080/13803395.2018.1438372 PMid:29502483.
  12. Beber BC, Cruz AN, Chaves ML. A behavioral study of the nature of verb production deficits in Alzheimer’s disease. Brain Lang. 2015;149:128-34. http://dx.doi.org/10.1016/j.bandl.2015.07.010 PMid:26291288.
  13. Narme P, Maillet D, Palisson J, Le Clésiau H, Moroni C, Belin C. How to assess executive functions in a low-educated and multicultural population using a switching verbal fluency test (the TFA-93) in neurodegenerative diseases? Am J Alzheimers Dis Other Demen. 2019;34(7-8):469-77. http://dx.doi.org/10.1177/1533317519833844 PMid:30827122.
  14. García-Herranz S, Díaz-Mardomingo MC, Venero C, Peraita H. Accuracy of verbal fluency tests in the discrimination of mild cognitive impairment and probable Alzheimer’s disease in older Spanish monolingual individuals. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2020;27(6):826-40. http://dx.doi.org/10.1080/13825585.2019.1698710 PMid:31822214.
  15. Williams E, McAuliffe M, Theys C. Language changes in Alzheimer’s disease: a systematic review of verb processing. Brain Lang. 2021;223:105041. http://dx.doi.org/10.1016/j.bandl.2021.105041 PMid:34688957.
  16. Östberg P, Fernaeus S-E, Hellström Å, Bogdanović N, Wahlund L-O. Impaired verb fluency: a sign of mild cognitive impairment. Brain Lang. 2005;95(2):273-9. http://dx.doi.org/10.1016/j.bandl.2005.01.010 PMid:16246735.
  17. Alegret M, Peretó M, Pérez A, Valero S, Espinosa A, Ortega G, et al. The role of verb fluency in the detection of early cognitive impairment in Alzheimer’s disease. J Alzheimers Dis. 2018;62(2):611-9. http://dx.doi.org/10.3233/JAD-170826 PMid:29480180.
  18. Troyer AK, Moscovitch M, Winocur G. Clustering and switching as two components of verbal fluency: evidence from younger and older healthy adults. Neuropsychology. 1997;11(1):138-46. http://dx.doi.org/10.1037/0894-4105.11.1.138 PMid:9055277.
  19. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology. 1984;34(7):939-44. http://dx.doi.org/10.1212/WNL.34.7.939 PMid:6610841.
  20. Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982;140(6):566-72. http://dx.doi.org/10.1192/bjp.140.6.566 PMid:7104545.
  21. Kochhann R, Varela JS, Lisboa CSM, Chaves MLF. The mini mental state examination review of cutoff points adjusted for schooling in a large Southern Brazilian sample. Dement Neuropsychol. 2010;4(1):35-41. http://dx.doi.org/10.1590/S1980-57642010DN40100006 PMid:29213658.
  22. Smirnova D, Clark M, Jablensky A, Badcock JC. Action (verb) fluency deficits in schizophrenia spectrum disorders: linking language, cognition and interpersonal functioning. Psychiatry Res. 2017;257:203-11. http://dx.doi.org/10.1016/j.psychres.2017.07.044 PMid:28772137.
  23. Paek EJ, Murray LL. Quantitative and qualitative analysis of verb fluency performance in individuals with probable Alzheimer’s disease and healthy older adults. Am J Speech Lang Pathol. 2021;30(1S):481-90. http://dx.doi.org/10.1044/2019_AJSLP-19-00052 PMid:32551834.
  24. Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420-8. http://dx.doi.org/10.1037/0033-2909.86.2.420 PMid:18839484.
  25. Gamer M, Lemon J, Singh IFP. Irr: various coefficients of interrater reliability and agreement. Viena: R Foundation for Statistical Computing; 2010.
  26. Fagundo AB, López S, Romero M, Guarch J, Marcos T, Salamero M. Clustering and switching in semantic fluency: predictors of the development of Alzheimer’s disease. Int J Geriatr Psychiatry. 2008;23(10):1007-13. http://dx.doi.org/10.1002/gps.2025 PMid:18416452.
  27. Weakley A, Schmitter-Edgecombe M. Analysis of verbal fluency ability in Alzheimer’s disease: the role of clustering, switching and semantic proximities. Arch Clin Neuropsychol. 2014;29(3):256-68. http://dx.doi.org/10.1093/arclin/acu010 PMid:24687588.
6462f969a9539556c222ed78 codas Articles
2317-1782 (Eletrônico)
CoDAS ©2024 Todos os direitos reservados.

CoDAS

Share this page
Page Sections