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EBP Compendium: Summary of Systematic Review

Verbal Fluency Performance in Dementia of the Alzheimer's Type: A Meta-Analysis

Henry, J. D., Crawford, J. R., et al. (2004).
Neuropsychologia, 42(9), 1212-1222.

Indicators of Review Quality:

The review addresses a clearly focused question No
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication Yes
Included studies are assessed for study quality No
Quality assessments are reproducible No

Description: This is a meta-analysis of studies comparing the phonemic and semantic fluency deficits of patients with dementia of the Alzheimer's type (DAT) relative to healthy controls.

Question(s) Addressed:

Question not specifically stated. 

Population: Adults with dementia of the Alzheimer's type.


  • WAIS Verbal and Vocabulary Scales (VIQ)
  • Trail Making Test Part A (TMT A)
  • Boston Naming Test (BNT)
  • Wechsler and Stone's Immediate Logical Memory test (ILM)
  • Mini Mental State Exam (MMSE)

Number of Studies Included: 153

Years Included: 1983 - October 2002



  • Assessment/Diagnosis
    • Assessment Areas
      • Verbal Fluency
        • Individuals with dementia of the Alzheimer's type were significantly more impaired on tests of semantic fluency compared to phonemic fluency.
        • The authors found semantic fluency to be characterized by a differential deficit in semantic memory storage. Deficits in semantic memory and effortful retrieval may be additive as semantic fluency was more significantly impaired than confrontation naming.
    • Assessment Instruments
      • Verbal Fluency
        • Although specific measures were not included, the authors concluded that measures of semantic and phonemic fluency were equivalent in sensitivity to executive control processes such as effortful retrieval. However, semantic fluency appeared to have greater demands on the semantic network.
        • Individuals with dementia of the Alzheimer's type were significantly more impaired on tests of semantic fluency and the Boston Naming Test than on tests measuring phonemic fluency. Deficits in semantic memory "reflect a degradation in the integrity of the semantic store, and not retrieval slowing" (p. 1220). However…semantic memory impairment appears to be especially pronounced when there are additionally substantial demands on effortful retrieval" (p. 1220).

Keywords: Alzheimer's Disease, Dementia

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Added to Compendium: March 2012

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