Verbal fluency with high executive load for early dementia’s risk detection

Abstract Verbal fluency (VF) tasks are used in cognitive assessments to detect early signs of neurodegenerative diseases like Alzheimer’s. This study aimed to assess the contribution of VF tasks with varying executive processing loads to the early identification of cognitive impairment in the preclinical stage of subjective cognitive decline (SCD). A total of 97 older adults were classified into three groups: healthy controls (HC), SCD and mild cognitive impairment (MCI). Participants completed phonemic, semantic, alternating and orthographic VF tasks. Education level significantly affected VF performance, with gender differences being inconsistent. The HC and SCD groups performed similarly in phonemic and semantic tasks but differed significantly in high-executive-load tasks, where SCD participants performed worse. MCI patients showed lower performance across all VF tasks. Discriminant and ROC analyses identified alternating and orthographic VF tasks as effective markers for distinguishing cognitive status, supporting their potential for early detection of Alzheimer’s disease.