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Peer-reviewedCC BY-NC 4.0Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring

Item‐level verbal fluency psycholinguistic metrics predict preclinical Alzheimer's disease

  • Michael A. Sugarman1
  • Mackenzie Stabile1
  • David G. Clark2
  • Paul J. Nietert3
  • Federico Rodriguez‐Porcel1
  • Justin Bushnell2
  • Andreana Benitez1
  1. 1Department of Neurology Medical University of South Carolina Charleston South Carolina USA
  2. 2Department of Neurology Indiana University School of Medicine Indianapolis Indiana USA
  3. 3Department of Public Health Sciences Medical University of South Carolina Charleston South Carolina USA
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Abstract

INTRODUCTION: Preclinical Alzheimer's disease (pAD) is characterized by subtle disruptions in semantic network functioning. Psycholinguistic metrics from item‐level responses during verbal fluency tasks could reflect these changes in the asymptomatic stage.

METHODS: We analyzed psycholinguistic metrics for Animal and F Fluency (age of acquisition [AoA], semantic neighborhood density [SND], and lexical frequency [LF]), testing whether these metrics differentiated 50 participants with positron emission tomography (PET)‐confirmed pAD (Aβ+) from 99 controls (Aβ‐) and predicted cognitive decline.

RESULTS: Aβ+ participants generated Animal Fluency responses with younger AoA, higher LF, and marginally higher SND than Aβ‐ (ds = 0.33‐0.44), despite comparable total scores. All three metrics predicted amyloid positivity in models controlling for age and total score. No significant findings were observed for F Fluency, and no metrics predicted cognitive decline.

DISCUSSION: Psycholinguistic metrics for Animal, but not F Fluency responses may reflect changes in semantic network functioning in pAD not captured by the total score.

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Cite

BibTeXRIS
BibTeX
@article{sugarman2026itemlevel,
  title = {{Item‐level verbal fluency psycholinguistic metrics predict preclinical Alzheimer's disease}},
  author = {Michael A. Sugarman and Mackenzie Stabile and David G. Clark and Paul J. Nietert and Federico Rodriguez‐Porcel and Justin Bushnell and Andreana Benitez},
  journal = {Alzheimer's \& Dementia : Diagnosis, Assessment \& Disease Monitoring},
  year = {2026},
  month = nov,
  doi = {10.1002/dad2.70533},
  url = {https://doi.org/10.1002/dad2.70533},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Item‐level verbal fluency psycholinguistic metrics predict preclinical Alzheimer's disease
AU  - Michael A. Sugarman
AU  - Mackenzie Stabile
AU  - David G. Clark
AU  - Paul J. Nietert
AU  - Federico Rodriguez‐Porcel
AU  - Justin Bushnell
AU  - Andreana Benitez
PY  - 2026
DA  - 2026/11/02
JO  - Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring
DO  - 10.1002/dad2.70533
UR  - https://doi.org/10.1002/dad2.70533
AB  - INTRODUCTION: Preclinical Alzheimer's disease (pAD) is characterized by subtle disruptions in semantic network functioning. Psycholinguistic metrics from item‐level responses during verbal fluency tasks could reflect these changes in the asymptomatic stage.  METHODS: We analyzed psycholinguistic metrics for Animal and F Fluency (age of acquisition [AoA], semantic neighborhood density [SND], and lexical frequency [LF]), testing whether these metrics differentiated 50 participants with positron emission tomography (PET)‐confirmed pAD (Aβ+) from 99 controls (Aβ‐) and predicted cognitive decline.  RESULTS: Aβ+ participants generated Animal Fluency responses with younger AoA, higher LF, and marginally higher SND than Aβ‐ (ds = 0.33‐0.44), despite comparable total scores. All three metrics predicted amyloid positivity in models controlling for age and total score. No significant findings were observed for F Fluency, and no metrics predicted cognitive decline.  DISCUSSION: Psycholinguistic metrics for Animal, but not F Fluency responses may reflect changes in semantic network functioning in pAD not captured by the total score.
SN  - 2352-8729
ER  -