Letter and Semantic Fluency in Older Adults: Effects of Mild Depressive Symptoms and Age-Stratified Normative Data

L. D. Ravdin, H. L. Katzen, P. Agrawal, N. R. Relkin

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Depression induced cognitive impairment, also referred to as the dementia syndrome of depression or pseudodementia, has been well characterized, yet the extent to which the more common mild depressive symptoms influence cognition has not been well studied. We sought to identify the influence of mild depressive symptoms on verbal fluency performance in a large sample of healthy community dwelling older adults. Letter and semantic fluency testing was conducted on 188 participants (ages 60-92 years) with no known history of neurologic or psychiatric disease. Depressive symptoms were assessed with the Geriatric Depression Scale (GDS). A total of 39 subjects obtained GDS scores consistent with mild depressive symptoms (GDS = 10-19), and 149 subjects were identified as not depressed (GDS < 10). ANOVA indicated that subjects with mild depressive symptoms performed significantly worse than normal controls on letter fluency (p < .05), but there was no significant difference between the groups on semantic fluency. Analysis of the nondepressed group stratified into young-old, middle-old, and oldest-old revealed a significant decline in semantic (p < .001) but not letter fluency with age. The nondepressed young-old showed the expected advantage for word list generation to semantic as compared to letter categories, yet this pattern was reversed in the older age groups, where letter fluency scores exceeded semantic fluency scores. Our results suggest that the presence of even mild depressive symptoms may confound using letter versus category discrepancies in the differential diagnosis of dementia. Further, our findings suggest that the commonly used strategy of examining letter-semantic fluency discrepancies may not be relevant for individuals of advanced age. Age-stratified normative data for fluency testing in older adults is also provided.

Original languageEnglish
Pages (from-to)195-202
Number of pages8
JournalClinical Neuropsychologist
Volume17
Issue number2
DOIs
StatePublished - May 1 2003

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Semantics
Depression
Geriatrics
Dementia
Fluency
Letters
Depressive Symptoms
Factitious Disorders
Independent Living
Cognition
Nervous System
Psychiatry
Analysis of Variance
Differential Diagnosis
Age Groups

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Letter and Semantic Fluency in Older Adults : Effects of Mild Depressive Symptoms and Age-Stratified Normative Data. / Ravdin, L. D.; Katzen, H. L.; Agrawal, P.; Relkin, N. R.

In: Clinical Neuropsychologist, Vol. 17, No. 2, 01.05.2003, p. 195-202.

Research output: Contribution to journalArticle

Ravdin, L. D. ; Katzen, H. L. ; Agrawal, P. ; Relkin, N. R. / Letter and Semantic Fluency in Older Adults : Effects of Mild Depressive Symptoms and Age-Stratified Normative Data. In: Clinical Neuropsychologist. 2003 ; Vol. 17, No. 2. pp. 195-202.
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