Semantic verbal fluency analysis in highly educated older adults

Brincker, Letícia; Pinheiro, Emanuelle Mirlley Lima; Cera, Maysa Luchesi; Satler, Corina

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Audiology - Communication Research

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Sumário

Original Article • Audiol., Commun. Res. 26 • 2021 • https://doi.org/10.1590/2317-6431-2021-2469 copy

Semantic verbal fluency analysis in highly educated older adults

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

to compare the performance of a group of highly educated, healthy older adults in the quantitative and qualitative analysis of the Semantic Verbal Fluency (SVF) test in the Animals and Fruits categories, the performance of the subgroups of participants (with high [HE] and very high [VHE] educational level) in both categories, as well as the performance between men and women.

Methods

The study included 31 older adults (> 60 years old), with eight years or more of formal education, from the Federal District (DF-Brazil). All performed the 60-second test in both categories. The following items were analyzed: total words, clustering, switching, intersection, return, test time, and errors, considering demographic variables such as gender and educational level (HE: 8 to 16 years; VHE: 17 to 25 years).

Results

Participants with VHE had a better performance in both categories, with a greater total number of words evoked for “animals” and a greater number of switches (p<0.05) for “fruits”. In relation to gender, men obtained a better performance for “animals” with the highest total number of evoked words and in the different time blocks (p<0.05) and greater number of clusters and intersections (p<0.001).

Conclusion

The performance of healthy older adults with a high educational level is influenced by demographic variables such as years of formal education and gender, suggesting that the application of the SVF should consider the impact of these variables, with a cautious interpretation of the results.

Keywords:
Aging; Cognition; Language; Education; Neuropsychological test

Variable	Total	Educational level
		High	Very high	p-value^* * Statistically significant value (p≤0.05)
Sample size	31	17	14	-
Percentage of women	70.96%	82.35%	57.14%	-
Age years)	69.25 ± 4.64	69.29 ± 5.05	69.21 ± 4.26	0.963
Educational level (years)	16.75 ± 4.39	13.50 ± 2.39	20.71 ± 2.61	0.001
MoCA	27.03 ± 1.40	26.82 ± 1.50	27.28 ± 1.26	0.370
BAI	5.16 ± 5.20	4.52 ± 3.84	5.92 ± 6.56	0.466
BDI-II	6.87 ± 4.68	7.47 ± 5.25	6.14 ± 3.95	0.442

	Category type
Variables	Animals	Fruits
Variables	Mean (SD)	Mean (SD)	p-value
Total words	22.59 (5.50)	16.44 (4.42)	0.001*
Total words (0-15s)	9.62 (2.84)	8.11 (2.11)	0.029*
Total words (15-30s)	5.00 (1.98)	3.74 (1.53)	0.011*
Total words (30-45s)	4.31 (1.96)	2.56 (1.57)	0.001*
Total words (45-60s)	3.66 (1.83)	2.04 (1.95)	0.002*
Total cluster (first letter)	2.34 (1.83)	3.15 (2.44)	0.168
Total switching (first letter)	18.86 (5.45)	12.33 (4.51)	0.001*
Total intersections (first letter)	2.34 (1.83)	3.15 (2.44)	0.168
Total returns (first letter)	9.17 (3.78)	5.04 (3.28)	0.001*
Total clusters (environment)	14.86 (4.43)	9.07 (2.99)	0.001*
Total switching (environment)	6.76 (2.66)	6.19 (2.54)	0.415
Total intersections (environment)	14.86 (4.43)	9.07 (2.99)	0.001 ^* * Statistically significant values (p≤0.05)
Total returns (environment)	4.69 (2.36)	4.15 (2.17)	0.378
Total clusters (class)	13.52 (4.76)	9.26 (3.44)	0.001*
Total switching (class)	7.93 (2.54)	6.04 (2.98)	0.013*
Total intersections (class)	13.52 (4.76)	9.26 (3.44)	0.001*
Total returns (class)	4.52 (1.59)	4.52 (2.66)	0.998
Total intrusions	0.007 (0.25)	0.19 (0.62)	0.359
Total repetitions/perseverance	1.14 (1.24)	0.85 (1.19)	0.386
Total continuous repetition	0.00 (0.00)	0.00 (0.00)	-
Total paraphasias	1.24 (1.30)	0.41 (0.57)	0.003*
Total leads	0.41 (0.82)	0.00 (0.00)	0.012*

	Animals			Fruits
	HE	VHE		HE	VHE
	n=16	n=13		n=15	n=12
Variables	Mean (SD)	Mean (SD)	p-value	Mean (SD)	Mean (SD)	p-value
Total words	20.7 (4.41)	24.8 (6.02)	0.044*	15.20 (3.07)	18.00 (5.42)	0.103
Total words (0-15s)	8.56 (2.75)	10.9 (2.46)	0.023*	8.33 (1.67)	7.83 (2.62)	0.553
Total words (15-30s)	4.75 (1.77)	5.30 (2.25)	0.461	3.46 (1.45)	4.08 (1.62)	0.309
Total words (30-45s)	3.81 (1.72)	4.92 (2.13)	0.133	2.13 (1.24)	3.08 (1.83)	0.122
Total words (45-60s)	3.62 (2.09)	3.69 (1.54)	0.924	1.26 (1.66)	3.00 (1.90)	0.019*
Total cluster (first letter)	2.12 (1.92)	2.61 (1.75)	0.485	3.46 (2.64)	2.75 (2.22)	0.460
Total switching (first letter)	17 (5.24)	21.1 (4.98)	0.039*	10.70 (3.08)	14.3 (5.31)	0.037*
Total intersections (first letter)	2.12 (1.92)	2.61 (1.75)	0.485	3.46 (2.64)	2.75 (2.22)	0.460
Total returns (first letter)	8.12 (3.11)	10.4 (4.23)	0.098	3.86 (2.32)	6.50 (3.80)	0.036*
Total clusters (environment)	13.5 (3.65)	16.5 (4.85)	0.065	8.53 (2.41)	9.75 (3.59)	0.304
Total switching (environment)	6.31 (2.08)	7.30 (3.25)	0.327	5.33 (1.98)	7.25 (2.83)	0.049 ^* * Statistically significant values (p≤0.05)
Total intersections (environment)	13.5 (3.65)	16.5 (4.85)	0.065	8.53 (2.41)	9.75 (3.59)	0.304
Total returns (environment)	4.43 (1.86)	5 (2.91)	0.533	3.46 (1.40)	5.00 (2.69)	0.068
Total clusters (class)	12.4 (4.93)	14.8 (4.35)	0.180	8.53 (1.95)	10.10 (4.64)	0.228
Total switching (class)	7.12 (2.33)	8.92 (2.53)	0.057	5.40 (2.94)	6.83 (2.94)	0.221
Total intersections (class)	12.4 (4.93)	14.8 (4.35)	0.180	8.53 (1.95)	10.10 (4.64)	0.228
Total returns (class)	4.06 (1.48)	5.07 (1.60)	0.089	4.00 (2.50)	5.16 (2.82)	0.267
Total intrusions	0.06 (0.25)	0.07 (0.27)	0.884	0.26 (0.79)	0.08 (0.28)	0.458
Total repetitions/perseverance	1.37 (1.25)	0.84 (1.21)	0.263	0.86 (1.24)	0.83 (1.19)	0.944
Total continuous repetition	0.00 (0)	0.00 (0)	-	0.00 (0)	0.00 (0)	-
Total paraphasias	1.12 (1.40)	1.38 (1.19)	0.602	0.26 (0.45)	0.58 (0.66)	0.157
Total leads	0.56 (0.96)	0.23 (0.59)	0.289	0.00 (0)	0.00 (0)	-

	Animals			Fruits
	Women	Men		Women	Men
	n=21	n=8		n=18	n=9
Variables	Mean (SD)	Mean (SD)	p-value	Mean (SD)	Mean (SD)	p-value
Total words	20.60 (3.61)	27.7 (6.47)	0.001 ^* * Statistically significant values (p≤0.05)	16.60 (3.94)	16.10 (5.51)	0.788
Total words (0-15s)	8.95 (2.65)	11.30 (2.72)	0.038*	8.61 (1.53)	7.11 (2.80)	0.083
Total words (15-30s)	4.76 (1.57)	5.62 (2.82)	0.303	3.44 (1.50)	4.33 (1.5)	0.160
Total words (30-45s)	3.76 (1.64)	5.75 (2.12)	0.012*	2.83 (1.68)	2.00 (1.22)	0.201
Total words (45-60s)	3.14 (1.87)	5.00 (0.75)	0.012*	1.72 (1.93)	2.66 (1.93)	0.243
Total cluster (first letter)	1.95 (1.39)	3.37 (2.50)	0.061	2.83 (1.38)	3.77 (3.83)	0.354
Total switching (first letter)	17.6 (4.05)	22.00 (7.52)	0.054	12.90 (4.13)	11.10 (5.23)	0.330
Total intersections (first letter)	1.95 (1.39)	3.37 (2.50)	0.061	2.83 (1.38)	3.77 (3.83)	0.354
Total returns (first letter)	8.04 (2.94)	12.1 (4.32)	0.007*	5.61 (3.22)	3.88 (3.29)	0.205
Total clusters (environment)	13.3 (2.97)	18.8 (5.27)	0.001*	9.27 (2.78)	8.66 (3.53)	0.627
Total switching (environment)	6.38 (2.24)	7.75 (3.53)	0.223	6.27 (2.39)	6.00 (2.95)	0.795
Total intersections (environment)	13.3 (2.97)	18.8 (5.27)	0.001*	9.27 (2.78)	8.66 (3.53)	0.627
Total returns (environment)	4.52 (2.01)	5.12 (3.22)	0.550	4.05 (1.73)	4.33 (3.00)	0.762
Total clusters (class)	11.7 (3.28)	18.2 (4.94)	0.001*	9.55 (3.31)	8.66 (3.84)	0.538
Total switching (class)	7.80 (2.33)	8.25 (3.19)	0.685	6.00 (3.34)	6.11 (2.26)	0.929
Total intersections (class)	11.7 (3.28)	18.2 (4.94)	0.001*	9.55 (3.31)	8.66 (3.84)	0.538
Total returns (class)	4.66 (1.59)	4.12 (1.64)	0.424	4.61 (2.97)	4.33 (2.06)	0.804
Total intrusions	0.04 (0.21)	0.12 (0.35)	0.480	0.11 (0.32)	0.33 (1.00)	0.392
Total repetitions/perseverance	1.19 (1.24)	1.00 (1.30)	0.720	0.94 (1.16)	0.66 (1.32)	0.581
Total continuous repetition	0.00 (0.00)	0.00 (0.00)	1.000	0.00 (0.00)	0.00 (0.00)	1.000
Total paraphasias	1.04 (0.97)	1.75 (1.90)	0.199	0.33 (0.48)	0.55 (0.72)	0.352
Total leads	0.28 (0.64)	0.75 (1.16)	0.180	0.00 (0.00)	0.00 (0.00)	1.000

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[1] Conflict of interests: No.