Objectives: This study presents data for semantic fluency, phonemic fluency, action fluency, and alternate fluency. The aim is to provide normative data by age, gender, and education for European Portuguese in each fluency category. Methods: Norms for the verbal fluency task were collected from a volunteer population of 444 healthy Portuguese participants. Multiple regression analysis with age, gender, and education as independent variables was performed for the semantic fluency global score, and these variables were considered separately for each phonemic category. Results: Age, education, and gender significantly affected the semantic global score, as well as scores of names, supermarket, kitchen objects, food, and clothes. No gender effect was observed in the categories “p-words,” animals, transports, verbs, and alternating fluency. This last category was only influenced by years of education. Conclusions: Equivalent scores of verbal fluency tasks are useful in clinical practice, allowing the comparison between the normal and the abnormal performance of language disorders.

1.
Warrington EK, Shallice T: Category specific semantic impairments. Brain 1984;107:829-854.
2.
Martin A: The representation of object concepts in the brain. Annu Rev Psychol 2007;58:25-45.
3.
Damasio H, et al: Neural systems behind word and concept retrieval. Cognition 2004;92:179-229.
4.
Capitani E, et al: What are the facts of semantic category-specific deficits? A critical review of the clinical evidence. Cogn Neuropsychol 2003;20:213-261.
5.
Gainotti G: What the locus of brain lesion tells us about the nature of the cognitive defect underlying category-specific disorders: a review. Cortex 2000;36:539-559.
6.
Papagno C, et al: Connectivity constraints on cortical reorganization of neural circuits involved in object naming. Neuroimage 2011;55:1306-1313.
7.
Gainotti G: The organization and dissolution of semantic-conceptual knowledge: is the “amodal hub” the only plausible model? Brain Cogn 2011;75:299-309.
8.
Phillips TJ, et al: Semantic fluency is impaired but phonemic and design fluency are preserved in early-onset schizophrenia. Schizophr Res 2004;70:215-222.
9.
Hodges JR, et al: The differentiation of semantic dementia and frontal lobe dementia (temporal and frontal variants of frontotemporal dementia) from early Alzheimer's disease: a comparative neuropsychological study. Neuropsychology 1999;13:31-40.
10.
Baldo JV, et al: Role of frontal versus temporal cortex in verbal fluency as revealed by voxel-based lesion symptom mapping. J Int Neuropsychol Soc 2006;12:896-900.
11.
Downes JJ, et al: Alternating fluency in Parkinson's disease. An evaluation of the attentional control theory of cognitive impairment. Brain 1993;116:887-902.
12.
Novelli G, et al: Test di ricerca e produzione lessicale. 1986. http://www.neuropsy.it.
13.
Spinnler H, Tognoni G: Italian standardization of neuropsychological tests (in Italian). Ital J Neurol Sci 1987(suppl 8):1-120.
14.
Capitani E, Laiacona M, Barbarotto R: Gender affects word retrieval of certain categories in semantic fluency tasks. Cortex 1999;35:273-278.
15.
Costa A, et al: Standardization and normative data obtained in the Italian population for a new verbal fluency instrument, the phonemic/semantic alternative fluency test. Neurol Sci 2013;35:365-372.
16.
Costa A, et al: Standardization and normative data obtained in the Italian population for a new verbal fluency instrument, the phonemic/semantic alternate fluency test. Neurol Sci 2014;35:365-372.
17.
Zarino B, et al: A new standardization of semantic verbal fluency test. Neurol Sci 2014;35:1405-1411.
18.
Casals-Coll M, et al: Spanish multicenter normative studies (NEURONORMA project): normative data and equivalence of four BNT short-form versions. Arch Clin Neuropsychol 2014;29:60-74.
19.
Van der Elst W, et al: 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;12:80-89.
20.
Cavaco S, et al: Semantic fluency and phonemic fluency: regression-based norms for the Portuguese population. Arch Clin Neuropsychol 2013;28:262-271.
21.
Tallberg IM, et al: Swedish norms for word fluency tests: FAS, animals and verbs. Scand J Psychol 2008;49:479-485.
22.
Troyer AK: Normative data for clustering and switching on verbal fluency tasks. J Clin Exp Neuropsychol 2000;22:370-378.
23.
Brucki S, Rocha M: Category fluency test: effects of age, gender and education on total scores, clustering and switching in Brazilian Portuguese-speaking subjects. Braz J Med Biol Res 2004;37:1771-1777.
24.
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;14:167-177.
25.
Harrison JE, et al: Short test of semantic and phonological fluency: normal performance, validity and test-retest reliability. Br J Clin Psychol 2000;39:181-191.
26.
Piatt AL, et al: Action verbal fluency normative data for the elderly. Brain Lang 2004;89:580-583.
27.
Birn RM, et al: Neural systems supporting lexical search guided by letter and semantic category cues: a self-paced overt response fMRI study of verbal fluency. Neuroimage 2010;49:1099-1107.
28.
Andreou G, Trott K: Verbal fluency in adults diagnosed with attention-deficit hyperactivity disorder (ADHD) in childhood. Atten Defic Hyperact Disord 2013;5:343-351.
29.
Zhao Q, Guo Q, Hong Z: Clustering and switching during a semantic verbal fluency test contribute to differential diagnosis of cognitive impairment. Neurosci Bull 2013;29:75-82.
30.
Pettit L, et al: Heterogeneity of letter fluency impairment and executive dysfunction in Parkinson's disease. J Int Neuropsychol Soc 2013;19:986-994.
31.
Federmeier KD, Kutas M, Schul R: Age-related and individual differences in the use of prediction during language comprehension. Brain Lang 2010;115:149-161.
32.
Federmeier KD, et al: The impact of semantic memory organization and sentence context information on spoken language processing by younger and older adults: an ERP study. Psychophysiology 2002;39:133-146.
33.
Shao Z, et al: What do verbal fluency tasks measure? Predictors of verbal fluency performance in older adults. Front Psychol 2014;5:772.
34.
Morgado J, et al: Cut-off scores in MMSE: a moving target? Eur J Neurol 2010;17:692-695.
35.
Loonstra AS, Tarlow AR, Sellers AH: COWAT metanorms across age, education, and gender. Appl Neuropsychol 2001;8:161-166.
36.
Lucas JA, et al: Mayo's older Americans normative studies: category fluency norms. J Clin Exp Neuropsychol 1998;20:194-200.
37.
Gladsjo JA, et al: Norms for letter and category fluency: demographic corrections for age, education, and ethnicity. Assessment 1999;6:147-178.
38.
Cullum CM, Filley CM, Kozora E: Episodic memory function in advanced aging and early Alzheimer's disease. J Int Neuropsychol Soc 1995;1:100-103.
39.
Mathuranath PS, et al: Effects of age, education and gender on verbal fluency. J Clin Exp Neuropsychol 2003;25:1057-1064.
40.
Stokholm J, Jorgensen K, Vogel A: Performances on five verbal fluency tests in a healthy, elderly Danish sample. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2013;20:22-33.
41.
Kempler D, et al: The effects of age, education, and ethnicity on verbal fluency. J Int Neuropsychol Soc 1998;4:531-538.
42.
Parker A, Parkin A, Dagnall N: Effects of saccadic bilateral eye movements on episodic and semantic autobiographical memory fluency. Front Hum Neurosci 2013;7:630.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.