Normative study of the category fluency test (CFT) from nationwide data on community-dwelling elderly in Korea Seung-Ho Ryu a , Ki Woong Kim b, *, Seolmin Kim a , Joon Hyuk Park c , Tae Hui Kim b , Hyun-Ghang Jeong b , Jeong Lan Kim d , Seok Woo Moon e , Jae Nam Bae f , Jong Chul Yoon g , Il Han Choo h , Dong Woo Lee i , Sung Man Chang j , Jin Hyeong Jhoo k , Shin-Kyum Kim l , Maeng Je Cho h a Department of psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, 4-12, Hwayangdong, Gwanggingu, 143-729, Seoul, Republic of Korea b Department of Neuropsychiatry, Seoul National University Bundang Hospital, 166 Gumiro, Bundanggu, Gyeonggi-do 463-707, Republic of Korea c Department of Neuropsychiatry, Jeju National University Hospital, 1753-3, Aradong, Jejusi, Jejudo, 690-756, Republic of Korea d Department of Psychiatry, Chungnam National University Hospital, 282 Munhwaro, Junggu, Daejeon, 301-721, Republic of Korea e Department of Psychiatry, Konkuk University Chungju hospital, 82, Kookwondaero, Chungjusi, Chungcheongbookdo, 380-704, Republic of Korea f Department of Psychiatry, Inha University Hospital, 7-206, Singheungdong, Junggu, Incheon, 400-711, Republic of Korea g Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, 4 Sanghadong, Kiheunggu, Yonginsi, Gyeonggido, 449-901, Republic of Korea h Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehakro, Jongnogu, Seoul, 110-744, Republic of Korea i Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, 761-1, Sanggyedong, Nowongu, Seoul, 139-707, Republic of Korea j Department of Psychiatry, Kyungbook National University Chilgok Hospital, 474, Hakjeongdong, Bukgu, Daegu, 702-210, Republic of Korea k Department of Neuropsychiatry, Kangwon National University School of Medicine, 156 Baengnyeongro, Chuncheonsi, Kangwondo, 200-722, Republic of Korea l Department of Neuropsychiatry, Gwangju Inkwang Dementia Hospital, 605-1, Samgeodong, Gwangsangu, Gwangju, 506-454, Republic of Korea 1. Introduction Assessment of verbal fluency has long been used for evaluating patient executive function, semantic memory and language (Benton, 1968; Lezak, 1995). Patient verbal fluency is typically tested in letter and category domains that are based on phonemic and semantic fluency, respectively. Clinicians most commonly assess letter fluency via various forms of the Controlled Oral Word Association Test (COWAT), which requires participants to produce words beginning with a certain letter of the alphabet (Ruff et al., 1996). In a category fluency assessment, participants are asked to name examples belonging in a particular category in 60 s trials. Clinicians most commonly employ the category ‘‘animals’’ (Rosen, 1980). This requires the participant to name as many animals as possible. Research has shown both these verbal fluency measures are sensitive to brain damage (Butters et al., 1987; Janowsky et al., 1989; Stuss et al., 1998). Category fluency and letter fluency differentially involve specific frontal and temporal lobe sites, and semantic fluency may be more sensitive to such damage than letter fluency is (Henry et al., 2004). Researchers have also demonstrated that differential performances on letter versus category fluencies have diagnostic utility in aging-related disorders, such as AD (Rosen, 1980; Monsch et al., 1992; Barr and Brandt, 1996). AD particularly reduces category fluency, whereas letter fluency remains relatively intact (Monsch et al., 1992). These observations are consistent with Archives of Gerontology and Geriatrics 54 (2012) 305–309 ARTICLE INFO Article history: Received 9 February 2011 Received in revised form 10 May 2011 Accepted 10 May 2011 Available online 14 July 2011 Keywords: Categorical verbal fluency Normative data Demography ABSTRACT Objectives: We determined the influence of demographic characteristics on the categorical verbal fluency and to provided its’ normative data for the community-dwelling elderly with diverse educational attainment. Methods: We administered the CFT using the animal category to 3025 (1420 men and 1605 women) non-demented community-dwelling Koreans aged 60–96 years who had educational levels ranging from 0 to 22 years. Results: Age and education were associated significantly with performance of CFT, with education showing the stronger association. Education accounted for 14.0% of CFT score variance and age accounted for 3.2%. However, gender did not influence performance of the test. We present normative data for CFT stratified by age (60–64, 65–69, 70–74, 75–79, 80–84, and 85 years) and education (0, 1–3, 4–6, 7–9, 10–12, and 13 years). Conclusions: The CFT norms should provide clinically useful data for evaluating elderly people and help improve the interpretation of verbal fluency tasks and allow for greater diagnostic accuracy for cognitive disorders such as Alzheimer’s disease (AD). ß 2011 Elsevier Ireland Ltd. All rights reserved. * Corresponding author. Tel.: +82 31 787 7439; fax: +82 31 787 4058. E-mail address: kwkimmd@snu.ac.kr (K.W. Kim). Contents lists available at ScienceDirect Archives of Gerontology and Geriatrics journal homepage: www.elsevier.com/locate/archger 0167-4943/$ – see front matter ß 2011 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.archger.2011.05.010