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Clinical Manifestations.

Matteo De Marco1, Sonia Di Tella2, Laura M Wright3

  • 1Brunel University London, Uxbridge, Middlesex, United Kingdom.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Individuals with mild cognitive impairment and Alzheimer's dementia (MCI/AD) show reduced clustering and switching abilities during Category Fluency (CF) tests. These findings suggest impaired semantic processing and control in MCI/AD.

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Area of Science:

  • Neuropsychology
  • Cognitive Neuroscience
  • Gerontology

Background:

  • Mild cognitive impairment and Alzheimer's dementia (MCI/AD) affect cognitive functions, including language and executive functions.
  • Category Fluency (CF) performance is a sensitive measure for assessing semantic memory and executive control.
  • Clustering and switching abilities during CF are key indicators of semantic processing efficiency.

Purpose of the Study:

  • To perform a meta-analysis characterizing clustering and switching abilities in adults with MCI/AD during CF tasks.
  • To compare the performance of individuals with MCI/AD to cognitively healthy controls.
  • To identify potential moderators influencing CF performance in MCI/AD.

Main Methods:

  • A comprehensive bibliographical search was conducted across multiple scientific databases.
  • Meta-analysis models were employed to analyze data from 29 selected studies, comparing MCI/AD individuals (n=1,778) with controls (n=3,632).
  • Mean cluster size (MCS) and number of switches (NOS) were extracted as primary outcomes, with age, education, and Mini Mental State Examination (MMSE) scores as moderators.

Main Results:

  • Individuals with MCI/AD demonstrated significantly smaller mean cluster sizes (G=0.30, p<0.001) compared to controls.
  • The MCI/AD group exhibited significantly fewer switches (G=0.85, p<0.001) during CF tasks.
  • Standard CF counts and MMSE scores were significant negative predictors of effect size, indicating poorer performance with lower scores.

Conclusions:

  • Category Fluency (CF) mean cluster size (MCS) and number of switches (NOS) are significantly reduced in individuals with MCI/AD.
  • These findings highlight deficits in both automatic semantic processing (clustering) and controlled executive functions (switching) in MCI/AD.
  • Quantifying MCS and NOS can aid in assessing semantic processing deficits in clinical settings for individuals with MCI/AD.