The Study on Verbal Fluency in Older Adults in Nonthaburi Province
Article Sidebar
Main Article Content
Abstract
Background: Verbal fluency assesses cognitive function in dementia and word retrieval in aphasia. However, the lack of data on verbal fluency among healthy older Thai individuals hinders comparisons with patient results. This is particularly concerning because older individuals are at higher risk for stroke and dementia. As Thailand has transitioned into an aging society, addressing this gap in data is essential.
Objective: This study aims to examine verbal fluency in Thai individuals aged 60 and above, focusing on factors such as age, gender, and education level affecting word count. The goal is to update Thai data, provide more assessment options, and enhance understanding of related factors. This will improve the accuracy of result interpretation and inform treatment planning.
Materials and methods: The study involved 147 healthy Thai individuals aged 60-89 living in Nonthaburi, Thailand. Participants must pass the Thai Mental State Examination (TMSE), visual screening by naming a picture and reading text, hearing screening through finger rubbing, oral reading (Noo Jaew Passage), and oral motor examinations to include only healthy participants without speech impairment. The speech-language pathologist, as an examiner, asks participants to generate words within a minute for each category (randomly assigned: animal, object, and food). Each intelligible and correct word in their category was scored. Researchers transcribed the recordings and counted the words produced.
Results: The average age of the total participants was 70.59 (SD=7.25) years, with 110 women (75%). The average words are: 19.35 (SD=5.25) animals, 20.18 (SD=6.70) objects, and 15.02 (SD=4.56) foods. Participants aged 60-69 exhibited the highest verbal fluency for animal, object, and food categories at 20.63 (SD=5.02), 21.86 (SD=6.19), and 16.35 (SD=4.71), respectively.
Conclusion: The study investigates verbal fluency in older Thai individuals in Nonthaburi, focusing on animal, object, and food categories. Results show that fluency declines with age. While higher education enhanced performance in the animal and object categories, it did not affect the food category. Gender significantly impacted the food category, with females performing better, possibly due to cultural roles. The data can be helpful in clinical assessments and future research on cognitive aging in Thai populations.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.
References
Senanarong V, Harnphadungkit K, Poungvarin N, Vannasaeng S, Chongwisal S, Chakorn T, et al. The Dementia and Disability Project in Thai Elderly: rational design methodology and early results. BMC Neurol. 2013; 13: 3. doi: 10.1186/1471-2377-13-3.
Foundation of Thai Gerontology Research and Development Institute (TGRI). Situation of the Thai Older Persons 2021. Nakhon Pathom: Institute for Population and Social Research, Mahidol University; 2021.
Suwanwela NC. Stroke epidemiology in Thailand. J Stroke. 2014; 16(1): 1-7. doi: 10.5853/jos.2014. 16.1.1.
Wangtongkum S, Sucharitkul P, Silprasert N, Inthrachak R. Prevalence of dementia among population age over 45 years in Chiang Mai, Thailand. J Med Assoc Thai. 2008; 91(11): 1685-90. PMID: 19127790.
Senanarong V, Poungvarin N, Sukhatunga K, Prayoonwiwat N, Chaisewikul R, Petchurai R, et al. Cognitive status in the community dwelling Thai elderly. J Med Assoc Thai. 2001; 84(3): 408-16. PMID: 11460944.
Jitapunkul S, Kunanusont C, Phoolcharoen W, Suriyawongpaisal P. Prevalence estimation of dementia among Thai elderly: a national survey. J Med Assoc Thai. 2001; 84(4): 461-7. PMID: 11460954.
Nichols E, Steinmetz JD, Vollset SE, Fukutaki K, Chalek J, Abd-Allah F, et al. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health. 2022; 7(2): e105-e125.doi: 10.1016/S2468-2667(21)00249-8.
Whiteside DM, Kealey T, Semla M, Luu H, Rice L, Basso MR, et al. Verbal Fluency: Language or Executive Function Measure? Appl Neuropsychol Adult. 2016; 23(1): 29-34.
doi: 10.1080/23279095.2015.1004574.
Teerapong W. The comparison of language abilities of Thai aphasic patients and Thai normal subjects by using Thai Adaptation of Western Aphasia Battery [Thesis]. Nakhon Pathom: Mahidol University; 2000.
Gandour J, Dardarananda R, Buckingham H, Viriyavejakul A. A Thai adaptation of the Boston Diagnostic Aphasia Examination. Crossroads. 1986; 2(3): 1-39.
Julayanont P, Tangwongchai S, Hemrungrojn S, Tunvirachaisakul C, Phanthumchinda K, Hongsawat J, et al. The Montreal cognitive assessment—basic: A screening tool for mild cognitive impairment in illiterate and low-educated elderly adults. J Am Geriatr Soc. 2015; 63(12): 2550-4.
doi: 10.1111/jgs.13820.
Charernboon T. Verbal fluency in the Thai elderly with mild cognitive impairment and elderly with dementia. J Ment Health Thai. 2018; 26(2): 91-102.
Muangpaisan W, Assantachai P, Sitthichai K, Richardson K, Brayne C. The distribution of Thai Mental State Examination Scores among non-demented elderly in suburban Bangkok metropolitan and associated factors. J Med Assoc Thai. 2015; 98(9): 916-24. PMID: 26591 404.
Ngamjarus C. n4Studies: Sample Size Calculation for an Epidemiological Study on a Smart Device. Siriraj Med J. 2016; 68(3): 160-70.
Statistics of Elderly Person in Thailand 2019 [Internet]. 2019. Available from: www.dop.go.th/download/ knowledge/th1580099938-275_1.pdf.
Department of Older Persons. Situation of The Thai Elderly 2019. Nakhon Pathom: Institute for Population and Social Research, Mahidol University, and Foundation of Thai Gerontology Research and Development Institute (TGRI); 2019.
Train the Brain Forum Committee. Thai mental state examination (TMSE). Siriraj Hosp Gaz. 1993; 45: 661-74.
Sindermsuk D. The survey of speech defects among prathom 4 students in Mitsampan School Group [Thesis]. Nakhon Pathom: Mahidol University; 1986.
Torres-Russotto D, Landau WM, Harding GW, Bohne BA, Sun K, Sinatra PM. Calibrated finger rub auditory screening test (CALFRAST). Neurology. 2009; 72(18): 1595-600.
doi: 10.1212/WNL.0b013e3181a41280.
Tombaugh TN, Kozak J, Rees L. Normative data stratified by age and education for two measures of verbal fluency: FAS and animal naming. Arch Clin Neuropsychol. 1999; 14(2): 167-77.
doi: 10.1093/arclin/ 14.2.167.
Brickman AM, Paul RH, Cohen RA, Williams LM, MacGregor KL, Jefferson AL, et al. Category and letter verbal fluency across the adult lifespan: relationship to EEG theta power. Arch Clin Neuropsychol. 2005; 20(5): 561-73. doi: 10.1016/j.acn.2004.12.006.
Knight RG, McMahon J, Green TJ, Skeaff CM. Regression equations for predicting scores of persons over 65 on the rey auditory verbal learning test, the mini-mental state examination, the trail making test, and semantic fluency measures. Br J Clin Psychol. 2006; 45(Pt 3): 393-402.
doi: 10.1348/014466505x68032.
Kempler D, Teng EL, Dick M, Taussig IM, Davis DS. The effects of age, education, and ethnicity on verbal fluency. J Int Neuropsychol Soc. 1998; 4(6): 531-8. doi: 10.1017/s1355617798466013.
Chan AS, Poon MW. Performance of 7-to 95-year-old individuals in a Chinese version of the category fluency test. J Int Neuropsychol Soc. 1999; 5(6): 525- 33. doi: 10.1017/s135561779956606x.
Ostrosky-Solis F, Gutierrez AL, Flores MR, Ardila A. Same or different? Semantic verbal fluency across Spanish-speakers from different countries. Arch Clin Neuropsychol. 2007; 22(3): 367-77.
doi: 10.1016/j. acn.2007.01.011.
Mathuranath PS, George A, Cherian PJ, Alexander A, Sarma SG, Sarma PS. Effects of age, education and gender on verbal fluency. J Clin Exp Neuropsychol. 2003; 25(8): 1057-64.
doi: 10.1076/jcen.25.8.1057.16736.
Kavé G. Phonemic fluency, semantic fluency, and difference scores: normative data for adult Hebrew speakers. J Clin Exp Neuropsychol. 2005; 27(6): 690-9. doi: 10.1080/13803390490918499.
Pekkala S, Goral M, Hyun J, Obler LK, Erkinjuntti T, Albert ML. Semantic verbal fluency in two contrasting languages. Clin Linguist Phon. 2009; 23(6): 431-45. doi: 10.1080/02699200902839800.
Ryu SH, Kim KW, Kim S, Park JH, Kim TH, Jeong HG, Kim JL, Moon SW, Bae JN, Yoon JC, Choo IH, Lee DW, Chang SM, Jhoo JH, Kim SK, Cho MJ. Normative study of the category fluency test (CFT) from nationwide data on community-dwelling elderly in Korea. Arch Gerontol Geriatr. 2012; 54(2): 305-9. doi: 10.1016/j. archger.2011.05.010.
Cavaco S, Gonçalves A, Pinto C, Almeida E, Gomes F, Moreira I, Fernandes J, Teixeira-Pinto A. Semantic fluency and phonemic fluency: regression-based norms for the Portuguese population. Arch Clin Neuropsychol. 2013; 28(3): 262-71. doi: 10.1093/arclin/ act001.
Vogel A, Stokholm J, Jørgensen K. Normative data for eight verbal fluency measures in older Danish adults. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2020; 27(1): 114-124.
doi: 10.1080/ 13825585.2019.1593935.
Villalobos D, Torres-Simón L, Pacios J, Paúl N, Del Río D. A Systematic Review of Normative Data for Verbal Fluency Test in Different Languages. Neuropsychol Rev. 2023; 33(4): 733-64.
doi: 10.1007/s11065-022- 09549-0.
Ardila A. A cross-linguistic comparison of category verbal fluency test (ANIMALS): a systematic review. Arch Clin Neuropsychol. 2020; 35(2): 213-25. doi: 10.1093/arclin/acz060.
Benito-Cuadrado MM, Esteba-Castillo S, Böhm P, Cejudo-Bolívar J, Peña-Casanova J. Semantic Verbal Fluency of Animals: A Normative and Predictive Study in a Spanish Population. J Clin Exp Neuropsychol. 2002; 24(8): 1117-22. doi: 10.1076/ jcen.24.8.1117.8376.
Gladsjo JA, Schuman CC, Evans JD, Peavy GM, Miller SW, Heaton RK. Norms for Letter and Category Fluency: Demographic Corrections for Age, Education, and Ethnicity. Assessment. 1999; 6(2): 147-78. doi: 10.1177/107319119900600204.
Kosmidis MH, Vlahou CH, Panagiotaki P, Kiosseoglou G. The verbal fluency task in the Greek population: Normative data, and clustering and switching strategies. J Int Neuropsychol Soc. 2004; 10(2): 164-72. doi: 10.1017/S1355617704102014.
da Silva CG, Petersson KM, Faísca L, Ingvar M, Reis A. The Effects of Literacy and Education on the Quantitative and Qualitative Aspects of Semantic Verbal Fluency. J Clin Exp Neuropsychol. 2004; 26(2): 266-77. doi: 10.1076/jcen.26.2.266.28089.
Van Der Elst WIM, Van Boxtel MPJ, Van Breukelen GJP, Jolles J. Normative data for the Animal, Profession, and Letter M Naming verbal fluency tests for Dutch speaking participants and the effects of age, education, and sex. J Int Neuropsychol Soc. 2006; 12(1): 80-9.
doi: 10.1017/S1355617706060115.
Capitani E, Laiacona M, Barbarotto R. Gender Affects Word Retrieval of Certain Categories in Semantic Fluency Tasks. Cortex. 1999;35(2):273-8. doi: 10.1016/s0010- 9452(08)70800-1.
Chandrangam K. The relationship between gender and women’s self-value in Bangkok metropolis [Thesis]. Bangkok: Chulalongkorn University; 2005.