Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece.
Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece.
Medicina (Kaunas). 2023 Oct 19;59(10):1860. doi: 10.3390/medicina59101860.
The present study explored the utilization of verbal fluency (VF) cognitive strategies, including clustering, switching, intrusions, and perseverations, within both semantic (SVF) and phonemic (PVF) conditions, across a continuum of neurocognitive decline, spanning from normal cognitive ageing (NC) to mild cognitive impairment (MCI) and its subtypes, amnestic (aMCI) and non-amnestic (naMCI), as well as AD. The study sample was derived from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) cohort. The sample included 1607 NC individuals, 146 with aMCI (46 single-domain and 100 multi-domain), 92 with naMCI (41 single-domain and 51 multi-domain), and 79 with AD. Statistical analyses, adjusting for sex, age, and education, employed multivariate general linear models to probe differences among these groups. Results showed that AD patients exhibited poorer performance in switching in both VF tasks and SVF clustering compared to NC. Similarly, the aMCI group performed worse than the NC in switching and clustering in both tasks, with aMCI performing similarly to AD, except for SVF switching. In contrast, the naMCI subgroup performed similarly to those with NC across most strategies, surpassing AD patients. Notably, the aMCI subgroup's poor performance in SVF switching was mainly due to the subpar performance of the multi-domain aMCI subgroup. This subgroup was outperformed in switching in both VF tasks by the single-domain naMCI, who also performed better than the multi-domain naMCI in SVF switching. No significant differences emerged in terms of perseverations and intrusions. Overall, these findings suggest a continuum of declining switching ability in the SVF task, with NC surpassing both aMCI and AD, and aMCI outperforming those with AD. The challenges in SVF switching suggest executive function impairment associated with multi-domain MCI, particularly driven by the multi-domain aMCI.
本研究探讨了在语义流畅性（SVF）和语音流畅性（PVF）条件下，连续体上的神经认知衰退从正常认知老化（NC）到轻度认知障碍（MCI）及其亚型，遗忘型（aMCI）和非遗忘型（naMCI），以及 AD 中，言语流畅性（VF）认知策略的利用，包括聚类、转换、侵入和持续。研究样本来自希腊纵向老龄化和饮食研究（HELIAD）队列。样本包括 1607 名 NC 个体、146 名 aMCI（46 名单域和 100 名多域）、92 名 naMCI（41 名单域和 51 名多域）和 79 名 AD。统计分析，调整性别、年龄和教育，采用多元广义线性模型来探测这些组之间的差异。结果显示，AD 患者在两种 VF 任务和 SVF 聚类中的转换表现均差于 NC。同样，与 NC 相比，aMCI 组在两种任务中的转换和聚类表现均较差，aMCI 与 AD 表现相似，除了 SVF 转换。相比之下，naMCI 亚组在大多数策略中表现与 NC 相似，优于 AD 患者。值得注意的是，aMCI 亚组在 SVF 转换中的表现不佳主要是由于多域 aMCI 亚组的表现不佳。该亚组在两种 VF 任务中的转换表现均优于单域 naMCI，而单域 naMCI 在 SVF 转换中的表现也优于多域 naMCI。在持续和侵入方面没有显著差异。总体而言，这些发现表明在 SVF 任务中，转换能力呈连续下降趋势，NC 优于 aMCI 和 AD，而 aMCI 优于 AD。SVF 转换中的挑战表明与多域 MCI 相关的执行功能障碍，特别是由多域 aMCI 驱动。
