Verbal fluency in institutionalized patients with schizophrenia: Age-related performance decline B Mary H. Kosmidis a,b, T , Vassilis P. Bozikas b , Christina H. Vlahou a,b , Grigoris Kiosseoglou a , George Giaglis a , Athanasios Karavatos b a Department of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece b 1st Department of Psychiatry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece Received 10 November 2003; accepted 16 February 2005 Abstract Several studies have reported a relatively stable level of cognitive deficits among patients with schizophrenia regardless of age, while others have suggested continued deterioration with age. We compared the performance of 42 institutionalized patients with schizophrenia and 42 age- and education-matched healthy controls on a semantic and phonemic verbal fluency test. Each group was divided into young participants (b 65 years old) and elderly participants (z 65 years old). We found a fluency condition  diagnostic group  age group interaction on total words produced, a fluency condition  diagnostic group interaction on the number of cluster-related words, and a fluency condition  age group interaction on the number of switches. Patients with schizophrenia generally used similar strategies (i.e., semantic or phonemic cluster-related words and switches) as healthy individuals when generating words, but to a lesser degree. We found a disproportionate decline in the elderly schizophrenic patients relative to that of healthy controls only on the phonemic, relative to the semantic test. This decline in performance appears related to the effects of aging rather than severity or chronicity of illness, duration of institutionalization, or a progressive degenerative process associated with the disorder. D 2005 Elsevier Ireland Ltd. All rights reserved. Keywords: Schizophrenia; Verbal fluency; Neuropsychology; Aging; Institutionalization 1. Introduction It is widely accepted that schizophrenic patients often exhibit impairment on a wide range of neuro- psychological functions such as memory, attention, motor skills, general intelligence, and spatial ability, as well as executive and language functions (Gold et al., 1994; Heinrichs and Zakzanis, 1998; Kremen et 0165-1781/$ - see front matter D 2005 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.psychres.2005.02.003 B An earlier version of this report was presented at the 10th Congress of the International Psychogeriatric Society on September 9–14, 2001, in Nice, France. T Corresponding author. Department of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece. Tel.: +30 231 099 7308; fax: +30 231 099 7384. E-mail address: kosmidis@psy.auth.gr (M.H. Kosmidis). Psychiatry Research 134 (2005) 233 – 240 www.elsevier.com/locate/psychres