What do verbal fluency tasks measure? Predictors of verbal fluency performance in older adults

Shao, Zeshu; Janse, Esther; Visser, Karina; Meyer, Antje S. · 2014 · OpenAlex-citations

DOI: 10.3389/fpsyg.2014.00772

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Summary

This study investigates the specific cognitive components that drive performance in verbal fluency tasks, specifically examining the relative contributions of verbal ability (VA) and executive control (EA) in older adults. Verbal fluency tests, which include category (semantic) and letter (phonemic) fluency, are widely used in clinical and research settings to assess cognitive functioning. However, these tasks are "hybrid" measures, relying on both lexical retrieval and executive processes like updating and inhibition. The authors aimed to disentangle these contributions to determine which cognitive skills predict performance in each task type, addressing a gap in understanding the validity of these tests for assessing specific cognitive domains in aging populations. The researchers assessed 82 Dutch-speaking older adults (mean age 71.77 years). Participants completed letter and category fluency tasks, where performance was measured by the total number of words produced, the reaction time to the first word (1st RT), and the mean subsequent reaction time. To isolate predictors, participants also completed separate assessments for vocabulary size (multiple-choice test), lexical access speed (picture naming task analyzed via ex-Gaussian decomposition), updating ability (operation span task), and inhibition ability (stop-signal task). Regression analyses were used to determine how these specific VA and EA indicators predicted fluency performance metrics. The results indicated that updating ability was the primary predictor for the total number of words produced in both letter and category fluency tasks. Vocabulary size significantly predicted the speed of the first response (1st RT) in both tasks. Additionally, lexical access speed predicted the 1st RT specifically for category fluency. In contrast, inhibition ability and the executive control component of lexical access (parameter τ) contributed little to predicting fluency performance. The findings suggest that while both tasks rely on executive updating, category fluency is more sensitive to verbal knowledge and access speed, whereas letter fluency is less dependent on these verbal factors. The study concludes that verbal fluency tasks are not pure measures of either verbal ability or executive control but rather hybrid instruments. Because updating ability drives the total output in both tasks, while verbal factors primarily influence the initial retrieval speed, the utility of these tasks for isolating specific cognitive deficits in clinical or research contexts is limited. The findings highlight the need for caution when interpreting fluency scores as indicators of specific cognitive domains, particularly in older adults where heterogeneity in executive and verbal skills is common.

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• executive function