Verbal fluency and awareness of functional deficits in people with early-stage dementia

Martyr, Anthony; Clare, Linda; Nelis, Sharon M.; Marková, Ivana S.; Roth, Ilona; Woods, Robert T.; Whitaker, Christopher J. and Morris, Robin G. (2012). Verbal fluency and awareness of functional deficits in people with early-stage dementia. The Clinical Neuropsychologist, 26(3) pp. 501–519.



Assessment of activities of daily living is an important element in the diagnosis of dementia, with research suggesting a link between functional ability and cognition. We investigated the relationship between self- and carer proxy-ratings of instrumental activities of daily living (iADL) and executive functioning in early-stage dementia. Ninety-six people with early-stage Alzheimer’s disease, vascular or mixed dementia and their carers completed the Functional Activities Questionnaire; people with dementia also completed a test of letter fluency. Letter fluency was associated with self-ratings of iADL, while carer proxy-ratings of iADL correlated with the age and Mini-Mental State Examination score of the person with dementia. Self-ratings of functioning were significantly lower than carer proxy-ratings. Further analysis found those with impaired letter fluency rated themselves as having greater difficulties in iADLs than the remaining letter fluency groups. People with early-stage dementia vary in the extent to which they are aware of iADL functioning, and difficulties with language production may contribute to better awareness of iADL impairments

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