Clustering and switching patterns in semantic verbal fluency among Chinese older adults: associations with cognitive function and dementia screening

This study examined semantic verbal fluency performance in Mandarin-speaking older adults from a digitally administered, community-based dementia screening project. Using Tongyici Cilin , a Chinese semantic knowledge base, we quantified word count, switching frequency, and cluster size in an animal fluency task. In Phase 1, a large community sample was used to assess associations between verbal fluency indices and cognitive measures of memory and orientation across age and education subgroups. Word count and switching frequency were consistently associated with cognitive performance, particularly among older adults and participants with lower education, whereas cluster size showed limited practical relevance. In Phase 2, a clinically characterized subsample was analyzed to compare participants with no cognitive impairment, mild cognitive impairment (MCI), and dementia. Both the MCI and dementia groups showed reduced word count and switching frequency relative to the no cognitive impairment group, while cluster size did not differ significantly across groups. These findings support digitally collected word count and switching frequency as useful indicators for community-based dementia screening among Chinese older adults.