View in EDS HTML Full Text PDF Full Text

Generation of Novel Ideas: Creativity in Alzheimer's Disease, Mild Cognitive Impairment, and Healthy Older Adults

Saved in:
Bibliographic Details
Title: Generation of Novel Ideas: Creativity in Alzheimer's Disease, Mild Cognitive Impairment, and Healthy Older Adults
Language: English
Authors: Georgia Marsh, Ohnmar Aung, Amelia Ceslis, Robert Adam, Philip Mosley, Jurgen Fripp, Gail A. Robinson
Source: Creativity Research Journal. 2025 37(3):342-357.
Availability: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 16
Publication Date: 2025
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: Creativity, Alzheimers Disease, Neurological Impairments, Older Adults, Severity (of Disability), Cognitive Ability, Aging (Individuals), Foreign Countries, College Students
Geographic Terms: Australia
Assessment and Survey Identifiers: Sentence Completion Test, Remote Associates Test
DOI: 10.1080/10400419.2024.2304498
ISSN: 1040-0419
1532-6934
Abstract: Creativity refers to the ability to produce ideas or actions that are novel and useful, incorporating convergent and divergent thinking. Currently, limited attention has been paid to changes in creativity with disease progression (e.g. mild cognitive impairment and Alzheimer's disease). Therefore, this study examined the patterns of creativity between healthy controls (n = 36), adults with mild cognitive impairment (MCI; n = 23), and adults with Alzheimer's disease (AD; n = 21). The study explored whether performance on creativity tasks can predict clinical group and contributing cognitive processes. Various cognitive tests were administered to participants, including measures of creativity. Our findings suggested that creative thought is reduced in individuals with MCI and AD, such that the AD group generated the lowest number of correct responses and made the most errors on all creativity tasks, indicating that creative ability decreases as dementia progresses. Performance on creativity tasks could also predict clinical group (depending on the task, ranging from 49% to 82% of those having MCI), indicating sensitivity to novel idea generation, which has been linked to frontal lobe impairment. Our findings suggested that core cognitive processes underlying creativity, including semantic knowledge and executive functions, are critical for producing new creative thoughts.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1493563
Database: ERIC
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
    Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwHn5Y_IgtR8yc_33LDhf8lQAAAA4zCB4AYJKoZIhvcNAQcGoIHSMIHPAgEAMIHJBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDLfQxzdYP4gu2JOKNwIBEICBmwDW7ERXYYjKCMXG4HfHZ4sJEqWQEyW978iwSppwwcm0Hr8XM_eOKwm2jt1C0jfIuXNYcY9nDvUoMAqK8r85F98BDeTWoZMSTVygUPO3gp_97wwXBHyR59A2eKJHDJtaoC7X3aQq5jBWZM6llegxNsUKpPbuBdiYCL9lAo-7GlZJNYhrYjMkP3K9sw8PYePeFhiFUIlTYH_Qj5pc
Text:
  Availability: 1
  Value: <anid>AN0186774307;7lo01jul.25;2025Jul23.02:56;v2.2.500</anid> <title id="AN0186774307-1">Generation of Novel Ideas: Creativity in Alzheimer's Disease, Mild Cognitive Impairment, and Healthy Older Adults </title> <p>Creativity refers to the ability to produce ideas or actions that are novel and useful, incorporating convergent and divergent thinking. Currently, limited attention has been paid to changes in creativity with disease progression (e.g. mild cognitive impairment and Alzheimer's disease). Therefore, this study examined the patterns of creativity between healthy controls (n = 36), adults with mild cognitive impairment (MCI; n = 23), and adults with Alzheimer's disease (AD; n = 21). The study explored whether performance on creativity tasks can predict clinical group and contributing cognitive processes. Various cognitive tests were administered to participants, including measures of creativity. Our findings suggested that creative thought is reduced in individuals with MCI and AD, such that the AD group generated the lowest number of correct responses and made the most errors on all creativity tasks, indicating that creative ability decreases as dementia progresses. Performance on creativity tasks could also predict clinical group (depending on the task, ranging from 49% to 82% of those having MCI), indicating sensitivity to novel idea generation, which has been linked to frontal lobe impairment. Our findings suggested that core cognitive processes underlying creativity, including semantic knowledge and executive functions, are critical for producing new creative thoughts.</p> <p>Creativity is the potential to produce ideas or actions that are both useful/adaptive and novel/original (Bellass et al., [<reflink idref="bib7" id="ref1">7</reflink>]; Feist, [<reflink idref="bib23" id="ref2">23</reflink>]; Stein, [<reflink idref="bib73" id="ref3">73</reflink>]; Sternberg, [<reflink idref="bib74" id="ref4">74</reflink>]). "Novel" means that the "creative product did not exist previously in precisely the same form; it arises from a reintegration of already existing materials or knowledge, but when it is completed, it contains elements that are new" (Stein, [<reflink idref="bib73" id="ref5">73</reflink>]). The term "useful" means that the creative product allows flexible adaptation when faced with unexpected and changing situations (Baas, De Dreu, & Nijstad, [<reflink idref="bib3" id="ref6">3</reflink>]; Runco, [<reflink idref="bib71" id="ref7">71</reflink>]). This definition is crucial for creativity research as it differentiates creative ideas from bizarre ideas, which are ideas that are novel, but lacking in usefulness (Flaherty, [<reflink idref="bib26" id="ref8">26</reflink>]; Hull, [<reflink idref="bib36" id="ref9">36</reflink>]).</p> <p>Creativity empowers individuals to face changing environmental situations by enabling them to produce novel solutions (Hull, [<reflink idref="bib36" id="ref10">36</reflink>]). Thus, creativity enables individuals to respond in innovative ways, facilitate problem-solving skills, develop adaptive behaviors, and maximize human functioning (Baas, De Dreu, & Nijstad, [<reflink idref="bib3" id="ref11">3</reflink>]; Bellass et al., [<reflink idref="bib7" id="ref12">7</reflink>]). In fact, creativity is essential in facilitating successful aging as it can increase the functional independence of older adults and optimize their capacity to live independently (Bellass et al., [<reflink idref="bib7" id="ref13">7</reflink>]; Hull, [<reflink idref="bib36" id="ref14">36</reflink>]). Therefore, within a context of an aging society and increasing prevalence of neurodegenerative disorders like Alzheimer's Disease, and the clear benefits of creativity for older adults, it is timely and imperative that we understand how creativity changes within healthy and pathological aging. There are only a small number of studies addressing differences in creativity between healthy older adults and clinical groups. The current study investigates differences in creativity between healthy older adults, and those clinically diagnosed with mild cognitive impairment (MCI) and Alzheimer's disease (AD).</p> <hd id="AN0186774307-2">Theories of creativity</hd> <p>No single theoretical framework currently exists that can explain the cognitive processes involved in creative thinking. Many have approached creativity by attempting to understand the underlying cognitive processes; that is, the creative-process approach, which examines the cognitive processes required during creative idea production (Finke, Ward, & Smith, [<reflink idref="bib24" id="ref15">24</reflink>]; Mednick, [<reflink idref="bib58" id="ref16">58</reflink>]). Creativity involves two primary components, the first being divergent thinking, which is the ability (or potential) to generate multiple different possible solutions in response to a single prompt (Guilford, [<reflink idref="bib34" id="ref17">34</reflink>]). A popular way to measure divergent thinking is via ideational fluency tasks (also known as Alternate Uses Task [AUT]), which requires individuals to generate as many conventional/known and unconventional/novel uses of an everyday object (e.g., table knife) as possible within a specified time period (Lezak, Howieson, Loring, Hannay, & Fischer, [<reflink idref="bib48" id="ref18">48</reflink>]; Robinson, Shallice, Bozzali, & Cipolotti, [<reflink idref="bib68" id="ref19">68</reflink>]). To successfully perform the AUT, participants must generate numerous responses that are both appropriate (depending on task demands) and different from past responses, which is dependent on the ability to access, search, and retrieve stored knowledge, and to create novel responses (Beaty et al., [<reflink idref="bib6" id="ref20">6</reflink>]; Turner, Cipolotti, Yousry, & Shallice, [<reflink idref="bib78" id="ref21">78</reflink>]). Divergent thinking is thought to be a key component of creativity, particularly during the generation phase of formulating creative ideas (Kleinmintz, Ivancovsky, & Shamay-Tsoory, [<reflink idref="bib41" id="ref22">41</reflink>]). Convergent thinking refers to the ability to produce a single correct solution to a prompt from amongst several alternatives, rather than multiple possible solutions (Guilford, [<reflink idref="bib34" id="ref23">34</reflink>]). One typical measure of convergent thinking is the Remote Associates Test (RAT), which requires individuals to generate a fourth word, when provided with three unrelated words, that forms an association with each of the given words (Mednick, [<reflink idref="bib58" id="ref24">58</reflink>]; e.g., cottage/swiss/cake are linked by "cheese").</p> <p>Prior research has emphasized two theories of creativity, those being (<reflink idref="bib1" id="ref25">1</reflink>) associative processes, and (<reflink idref="bib2" id="ref26">2</reflink>) controlled attention (Beaty et al., [<reflink idref="bib6" id="ref27">6</reflink>]; Hull, [<reflink idref="bib36" id="ref28">36</reflink>]; Kleinmintz, Ivancovsky, & Shamay-Tsoory, [<reflink idref="bib41" id="ref29">41</reflink>]). The associative theory of creative thought subscribes to the notion that creativity is a "bottom-up" (e.g., unconscious, automatic) process, where creative ideas result from individual differences in associative hierarchies or semantic knowledge (Beaty et al., [<reflink idref="bib6" id="ref30">6</reflink>]; Mednick, [<reflink idref="bib58" id="ref31">58</reflink>]). The controlled attention theory of creativity considers creative thought as a goal-directed, "top-down" (e.g., strategic, controlled) process (Beaty et al., [<reflink idref="bib6" id="ref32">6</reflink>]; Hull, [<reflink idref="bib36" id="ref33">36</reflink>]). The theory views variability in creative thinking as a result of individual differences in the ability to control attention and cognition, taking an executive process standpoint (Gilhooly, Fioratou, Anthony, & Wynn, [<reflink idref="bib33" id="ref34">33</reflink>]).</p> <p>Recently, the cyclical relationship between associative processes and controlled attention has been highlighted, suggesting a two-fold model that balances generation and evaluation processes to support optimal creative performance (Kleinmintz, Ivancovsky, & Shamay-Tsoory, [<reflink idref="bib41" id="ref35">41</reflink>]). Kleinmintz, Ivancovsky, and Shamay-Tsoory ([<reflink idref="bib41" id="ref36">41</reflink>]) proposed that the "generation phase" of creative ideas stems from the activation of a semantic network aiming to combine remote associations in a new and original way. This phase is suggested to be mediated by the default-mode network, including the midline and posterior inferior parietal regions, which is thought to underlie the process of combining ideas and divergent thinking (Beaty et al., [<reflink idref="bib6" id="ref37">6</reflink>]; Volle, [<reflink idref="bib80" id="ref38">80</reflink>]; Zhang, Sjoerds, & Hommel, [<reflink idref="bib85" id="ref39">85</reflink>]). The right superior temporal gyrus has also been implicated in semantic doing and formation of remote and novel associations, indicating that it may be important for idea generation (Jung-Beeman et al., [<reflink idref="bib38" id="ref40">38</reflink>]; Kounios et al., [<reflink idref="bib44" id="ref41">44</reflink>]; Li, Li, Ji, Zhang, & Qiu, [<reflink idref="bib49" id="ref42">49</reflink>]). The "evaluation phase" is suggested to be mediated by a fronto-parietal network, which implicates executive control in creative thought. Specifically, the dorsolateral prefrontal cortex, left inferior frontal gyrus, and the right hemisphere (in particular, the right parietal cortex) are shown to be involved with divergent and/or convergent thinking performance (Zhang, Sjoerds, & Hommel, [<reflink idref="bib85" id="ref43">85</reflink>]). Executive control is associated with higher-order processes such as initiation, inhibition, working memory, planning, and problem solving. However, it has been proposed that executive control does not satisfy all processes involved in the evaluation phase, wherein the role of emotional processing, memory retrieval, monitoring of creative quality of ideas, and the selection of ideas, are further highlighted (Kleinmintz, Ivancovsky, & Shamay-Tsoory, [<reflink idref="bib41" id="ref44">41</reflink>]).</p> <hd id="AN0186774307-3">Healthy ageing and creativity</hd> <p>Age-related cognitive changes are associated with higher susceptibility to distraction and disinhibition (Hull, [<reflink idref="bib36" id="ref45">36</reflink>]; Kim, Hasher, & Zacks, [<reflink idref="bib40" id="ref46">40</reflink>]). Distraction and disinhibition impede task performance, where older individuals experience more distraction and disinhibition than younger individuals (Kim, Hasher, & Zacks, [<reflink idref="bib40" id="ref47">40</reflink>]). However, Kim, Hasher, and Zacks ([<reflink idref="bib40" id="ref48">40</reflink>]) also found that distraction and disinhibition in the form of poor attentional control was beneficial on a subsequent creative thinking task. Additionally, a robust semantic memory store that results from life-long experience and learning means that creativity is likely to increase with age (Carson, [<reflink idref="bib18" id="ref49">18</reflink>]). However, in healthy aging, declines in executive functions are experienced, such that individuals are impaired in cognitive tasks that require initiation, inhibition, strategic processes and rapid processing speed, and therefore may be impaired in tasks requiring divergent and convergent thinking (Gibson, Barker, Martin, & Robinson, [<reflink idref="bib32" id="ref50">32</reflink>]; Martin, Barker, Gibson, & Robinson, [<reflink idref="bib53" id="ref51">53</reflink>]; Murman, [<reflink idref="bib59" id="ref52">59</reflink>]; Salthouse, [<reflink idref="bib72" id="ref53">72</reflink>]). Natural changes in hippocampal subfields also occur through healthy aging, which can have implications for memory consolidation, spatial learning, and emotional regulation (Bettio, Rajendran, & Gil-Mohapel, [<reflink idref="bib10" id="ref54">10</reflink>]). Changes within the hippocampi extend to cortical regions as shown by recent fMRI evidence that there is functional integration of hippocampal connectivity gradients with large-scale cortical networks (e.g., default mode), which also adapt with naturalistic memory processing and change in the context of MCI and AD (Borne et al., [<reflink idref="bib13" id="ref55">13</reflink>]).</p> <hd id="AN0186774307-4">Alzheimer's disease and creativity</hd> <p>As neurodegenerative disorders progress, creativity has been found to decrease, due to prefrontal cortex dysfunction (Palmiero, Di Giacomo, & Passafiume, [<reflink idref="bib61" id="ref56">61</reflink>]). The prefrontal cortex is essential for creative thinking because idea generation, inhibition, and the creation of novel responses are cognitive functions associated with this brain region (Fuster, [<reflink idref="bib30" id="ref57">30</reflink>]; Robinson et al., [<reflink idref="bib67" id="ref58">67</reflink>]; Robinson, Shallice, Bozzali, & Cipolotti, [<reflink idref="bib68" id="ref59">68</reflink>]). Additionally, AD can lead to deterioration in episodic memory, often associated with early and progressive atrophy of the medial temporal region (McDonald et al., [<reflink idref="bib54" id="ref60">54</reflink>]), and, as noted above, changes within hippocampal functional integration with cortical networks such as the default mode network (Borne et al., [<reflink idref="bib13" id="ref61">13</reflink>]). Semantic control, defined as our ability to use, manipulate, and generalize knowledge that has been developed throughout our lifespans, is also implemented within frontal and temporoparietal networks (Lambon Ralph, Jefferies, Patterson, & Rogers, [<reflink idref="bib46" id="ref62">46</reflink>]). As described in the creative thought theories, semantic memory has been found to support both verbal and nonverbal creative thinking, and is considered to be crucial to performance on creativity tasks (Gerver, Griffin, Dennis, & Beaty, [<reflink idref="bib31" id="ref63">31</reflink>]). Therefore, it is reasonable to assume that as neurodegeneration progresses, creative thought performance progressively becomes poorer. Hippocampal volume has been well established as a biomarker of AD; however, may lack specificity and sensitivity within MCI, as it can surface in other, non-AD forms of dementia (Pini et al., [<reflink idref="bib64" id="ref64">64</reflink>]).</p> <p>Abstract thinking, visual reasoning, perception, executive function, and ideational fluency have also been documented to deteriorate in AD (Bigler, [<reflink idref="bib11" id="ref65">11</reflink>]; Bigler et al., [<reflink idref="bib12" id="ref66">12</reflink>]; de Souza et al., [<reflink idref="bib20" id="ref67">20</reflink>]; Hart & Wade, [<reflink idref="bib35" id="ref68">35</reflink>]; Katzman et al., [<reflink idref="bib39" id="ref69">39</reflink>]; Kumar, Koirala, & Tiwari, [<reflink idref="bib45" id="ref70">45</reflink>]; Palmiero, Di Giacomo, & Passafiume, [<reflink idref="bib61" id="ref71">61</reflink>]; Verma & Howard, [<reflink idref="bib79" id="ref72">79</reflink>]). Even if semantic memory is unimpaired, those with Alzheimer's disease may experience difficulties in thinking flexibly or efficiently accessing, searching, and retrieving information in semantic memory (Beaty et al., [<reflink idref="bib6" id="ref73">6</reflink>]; Palmiero, Di Giacomo, & Passafiume, [<reflink idref="bib61" id="ref74">61</reflink>]; Verma & Howard, [<reflink idref="bib79" id="ref75">79</reflink>]). This is supported by evidence showing that divergent thinking was impaired early in the AD group, such that their performance on the AUT was significantly lower than controls (Hart & Wade, [<reflink idref="bib35" id="ref76">35</reflink>]). These deficits in non-memory domains are also considered to align with neocortical atrophy that occurs with AD progression, where cortical atrophy extends along a temporal-parietal-frontal trajectory (Frisoni, Prestia, Rasser, Bonetti, & Thompson, [<reflink idref="bib29" id="ref77">29</reflink>]; Pini et al., [<reflink idref="bib64" id="ref78">64</reflink>]). Thalamic nuclei with connections to the temporal and prefrontal cortices have been shown to be impaired in AD, as has the basal ganglia, which are essential for suppressing irrelevant sensory input, attention, executive functions, and declarative memory (Pini et al., [<reflink idref="bib64" id="ref79">64</reflink>]; Yi et al., [<reflink idref="bib84" id="ref80">84</reflink>]). Again, as creativity is thought to involve an executive control component, mediated by the fronto-parietal network, it is likely that AD progression will affect performance on creative thought tasks.</p> <hd id="AN0186774307-5">Mild cognitive impairment and creativity</hd> <p>MCI is characterized by memory impairment more severe than expected for age without functional impairment (Albert et al., [<reflink idref="bib1" id="ref81">1</reflink>]; Traykov et al., [<reflink idref="bib76" id="ref82">76</reflink>]). Not everyone with MCI goes on to develop AD; however, individuals with MCI are more likely to develop AD compared to individuals without MCI (Farias, Mungas, Reed, Harvey, & DeCarli, [<reflink idref="bib22" id="ref83">22</reflink>]). To date, ideational fluency as measured by the AUT has not been investigated in MCI. Impairments in memory, attention, and executive functions are common in MCI (Perry, Watson, & Hodges, [<reflink idref="bib62" id="ref84">62</reflink>]; Petersen et al., [<reflink idref="bib63" id="ref85">63</reflink>]; Rapp & Reischies, [<reflink idref="bib65" id="ref86">65</reflink>]), which are crucial processes to receive a high score on the AUT. Recent research has highlighted the utility of measures of semantic richness and depth of knowledge in differentiating MCI from healthy older adults, related to the medial temporal lobe and its early deterioration in AD progression (Klooster & Duff, [<reflink idref="bib42" id="ref87">42</reflink>]; Klooster et al., [<reflink idref="bib43" id="ref88">43</reflink>]). Klooster et al. ([<reflink idref="bib43" id="ref89">43</reflink>]) further identified that MCI participants show deficits in complex tasks that require language and meaning, rather than all complex thought tasks. Additionally, MCI patients experience a deterioration in episodic memory, response initiation and inhibition, attentional switching, cognitive flexibility, and abstract thinking, when compared to controls (Lonie et al., [<reflink idref="bib50" id="ref90">50</reflink>]; Traykov et al., [<reflink idref="bib76" id="ref91">76</reflink>]; Verma & Howard, [<reflink idref="bib79" id="ref92">79</reflink>]). Hence, it would be reasonable to assume that creativity in the MCI group will be more impaired than the healthy older controls, but less impaired compared to the AD group.</p> <p>Although cognitive deterioration in AD has been extensively studied, limited attention has been paid to changes in creativity with disease progression. More specifically, there is currently no investigations of (<reflink idref="bib1" id="ref93">1</reflink>) creativity in MCI and (<reflink idref="bib2" id="ref94">2</reflink>) the differences in creativity between healthy older adults, and MCI and AD. In addition, there is little research exploring the processes underlying creative thought in these populations across a wide range of verbal and non-verbal divergent and convergent thinking tasks. As noted, it is important to understand the role of creative thought in clinical groups and older healthy adults to appreciate the implications in everyday problem solving, rehabilitation, and to optimize an individuals' functioning (Alfonso-Benlliure, Mayordomo, Sales, & Mélendez, [<reflink idref="bib2" id="ref95">2</reflink>]; Baas, De Dreu, & Nijstad, [<reflink idref="bib3" id="ref96">3</reflink>]; Bellass et al., [<reflink idref="bib7" id="ref97">7</reflink>]).</p> <hd id="AN0186774307-6">The present study</hd> <p>Thus, we aimed to:</p> <hd id="AN0186774307-7">Experiment 1</hd> <p></p> <ulist> <item> Investigate patterns of creativity between older healthy controls, and older adults with MCI or AD. The tasks administered to investigate creativity include the AUT and Design Fluency (primarily measures of divergent thinking), and the RAT and Anagrams (measures of convergent thinking). Specifically, we predict that: (i) the AD group will generate the lowest number of responses on tests of divergent and convergent thinking, and (ii) the AD and MCI groups will generate a significantly higher number of errors in the divergent and convergent thinking tasks, compared to controls. We also aim here to explore baseline cognitive functioning in all participants so as to develop greater insight into which functions may impact creativity. The tests utilized for this include assessments of premorbid IQ, memory, naming, and education.</item> <p></p> <item> Investigate whether performance on a creativity task can predict clinical group (i.e., MCI and AD). Generally, AD patients have been reported to be less able to generate novel responses than healthy controls (Hart & Wade, [<reflink idref="bib35" id="ref98">35</reflink>]). Therefore, we hypothesize that performance on measures of divergent and convergent thinking will predict the AD clinical group. As less is known about the deterioration of creativity in MCI, we aim to investigate whether performance on creativity tasks can predict MCI group.</item> <p></p> <item> Explore the additional cognitive processes that may contribute to the creation of novel responses. As the semantic network is thought to be involved in the generation of novel ideas and divergent thinking, it represents a key concept in the associative theory of creativity, and it deteriorates as AD progresses (Kleinmintz, Ivancovsky, & Shamay-Tsoory, [<reflink idref="bib41" id="ref99">41</reflink>]; Verma & Howard, [<reflink idref="bib79" id="ref100">79</reflink>]). If it contributes to the creation of novel responses, measures of semantic cognition (e.g., object characteristics task, semantic fluency) will positively correlate with creativity tasks. Further, convergent and divergent thinking are associated with executive control and evaluation of novel ideas, core components of the two-fold model of creativity/controlled attention theory (Kleinmintz, Ivancovsky, & Shamay-Tsoory, [<reflink idref="bib41" id="ref101">41</reflink>]; Robinson, Shallice, Bozzali, & Cipolotti, [<reflink idref="bib68" id="ref102">68</reflink>]), and prefrontal dysfunction that is considered a hallmark of AD and MCI (Guarino et al., 2019; Traykov et al., [<reflink idref="bib76" id="ref103">76</reflink>]). Therefore, if executive processes are involved in the creation of novel responses, then tasks that tap executive functions (e.g., response initiation and suppression, Hayling Sentence Completion Task) will correlate with performance on creativity tasks.</item> </ulist> <hd id="AN0186774307-8">Experiment 2</hd> <p></p> <ulist> <item> (<reflink idref="bib4" id="ref104">4</reflink>) Investigate scoring of the AUT by naïve raters, undergraduate first-year psychology students, who are blind to the participants' diagnoses. The AUT is widely used in creativity research and it is possible that there is a degree of subjectivity in scoring responses as being novel/creative or not. Therefore, we aimed to directly investigate whether trained neuropsychologists and naïve raters score the AUT in the same way. Thus, the scores of the ideational fluency tasks obtained from neuropsychologists and naïve raters will be compared for the three participant groups, and it is hypothesized that the ratings will not differ for both conventional and unconventional responses.</item> </ulist> <hd id="AN0186774307-9">Materials and methods</hd> <p></p> <hd id="AN0186774307-10">Experiment 1</hd> <p></p> <hd id="AN0186774307-11">Participants</hd> <p>We recruited 80 participants comprising 36 older healthy controls (HC: 39% males), 23 MCI participants (58% males), and 21 AD participants (33% males). The healthy older controls were recruited from the community, while clinical participants (MCI, AD), were recruited for the Prospective Imaging Study of Ageing (PISA; Lupton et al., [<reflink idref="bib51" id="ref105">51</reflink>]). Dementia diagnoses were determined by neurological examination, neuropsychological assessment and review of the neuroimaging (MRI), based on clinical diagnostic criteria (AD: McKhann et al., [<reflink idref="bib57" id="ref106">57</reflink>]; MCI: Albert et al., [<reflink idref="bib1" id="ref107">1</reflink>]). A detailed structured interview with patients and informants about function and activities of daily living (ADLs) was also carried out to ensure that the diagnosis was either MCI (if no change in function and basic/instrumental ADLs) or AD (if change in function and basic/instrumental ADLs), as per criteria (Albert et al., [<reflink idref="bib1" id="ref108">1</reflink>]; McKhann et al., [<reflink idref="bib57" id="ref109">57</reflink>]). Subsequent to this clinical diagnosis based on criteria, each patient was reviewed in a PISA case conference in which diagnosis of AD was further substantiated with the biomarker results of Positron Emission Tomography (PET) scans with a diagnostic radiotracer selective for binding with amyloid (details in Lupton et al., [<reflink idref="bib51" id="ref110">51</reflink>]). Mean ages and standard deviations are provided in Table 1. It was found that, the majority of participants fell within a moderate range of impairment based on clinical criteria, with a few regarded as mildly impaired.</p> <p>Table 1. Definitions and examples of the four categories provided to the naïve raters.</p> <p> <ephtml> <table><thead><tr><td>Category</td><td>Definitions</td><td>Examples (object: <italic>chair</italic>)</td></tr></thead><tbody><tr><td>Conventional</td><td>Common, usual, traditional uses</td><td>"For sitting on"</td></tr><tr><td>Unconventional but useful</td><td>Uncommon, unusual, non-traditional but useful uses</td><td>"As a paperweight"</td></tr><tr><td>Unconventional and bizarre</td><td>Uncommon, unusual, and non-traditional as well as odd, strange, and unexpected uses</td><td>"For time travel"</td></tr><tr><td>Error</td><td>Irrelevant responses</td><td>"My cup is empty"</td></tr></tbody></table> </ephtml> </p> <hd id="AN0186774307-12">Procedure</hd> <p>Experienced neuropsychologists administered all cognitive tests to the three participant groups (HC, MCI, AD), according to standardized manual instructions, as part of a larger set of tests.</p> <p>Materials and Measures</p> <p>Baseline Cognitive Measures</p> <hd id="AN0186774307-13">Crystallised Intelligence and Naming</hd> <p>The National Adult Reading Test – Second Edition (NART; Nelson & Willison, [<reflink idref="bib60" id="ref111">60</reflink>]) is a measure of crystallized intelligence that also provides a pre-morbid intelligence estimate (Bright, Hale, Gooch, Myhill, & van der Linde, [<reflink idref="bib15" id="ref112">15</reflink>]; Bright, Jaldow, & Kopelman, [<reflink idref="bib16" id="ref113">16</reflink>]). The number of errors was noted, and then converted into an estimated pre-morbid IQ score, which provides insight into the participants' baseline general cognitive functioning. The Graded Naming Test (GNT (McKenna & Warrington, [<reflink idref="bib56" id="ref114">56</reflink>]; Warrington, [<reflink idref="bib82" id="ref115">82</reflink>]); was developed to detect difficulties in naming abilities. The number of correct responses was recorded.</p> <hd id="AN0186774307-14">Semantic and Visual/Verbal Episodic Memory</hd> <p>The Object Characteristics Task (OCT; Fink et al., [<reflink idref="bib25" id="ref116">25</reflink>]) was used to establish baseline semantic knowledge. This assessment contributes to understanding whether creativity is reliant on an intact semantic knowledge network, as providing novel responses requires participants to access, search, and retrieve stored knowledge. Responses are correct if they represented common characteristics, and the total correct responses were tallied to obtain a score. Perseverative responses and rule-break errors were excluded. The Recognition Memory Test (RMT (Warrington, [<reflink idref="bib81" id="ref117">81</reflink>]); consists of word and unfamiliar face recognition. The number of correct responses were recorded for each task separately. This measure was used to determine if memory is reduced in the participants and how that might influence creativity.</p> <hd id="AN0186774307-15">Executive Functions</hd> <p>The Hayling Sentence Completion Test (HSCT; Burgess & Shallice, [<reflink idref="bib17" id="ref118">17</reflink>]) was used to assess initiation and suppression of a prepotent response (i.e., inhibition). The task consists of two sections; Section 1 requires participants to complete a sentence with a connected word, and Section 2 requires participants to complete a sentence with a nonsense word unconnected to the sentence. The number of errors (Type A: word connected to the sentence; Type B: word is semantically related to the sentence) was converted to a scaled score ranging from 1 to 10 (6 = average) to generate a measure of suppression of a pre-potent response. The Section 1 cumulative response times were converted to a scaled score as a measure of initiation, and Section 2 cumulative response times were also converted as a measure of inhibition (Burgess & Shallice, [<reflink idref="bib17" id="ref119">17</reflink>]). All HSCT measures were used to evaluate aim three, wherein we are interested in understanding if executive processes contribute to creative thought.</p> <p>Phonemic (F.A.S) and semantic (Animals) word fluency tasks were administered (Benton, [<reflink idref="bib9" id="ref120">9</reflink>]; Robinson, Shallice, Bozzali, & Cipolotti, [<reflink idref="bib68" id="ref121">68</reflink>]). These tasks require initiation and energization, idea selection amongst competing demands, and suppression of responded at the end of a period. Therefore, fluency tasks are used here for evaluating executive control contributions to creative thought. These tasks also require semantic memory retrieval, and thus may be useful in determining whether the semantic network is important in creativity. Participants were required to orally generate as many words beginning with the letters "F", "A", and "S" as possible within 60 seconds, and as many items from the category "Animals" as possible, respectively. The total number of words generated (minus errors and repetitions) were tallied to obtain a final score.</p> <hd id="AN0186774307-16">Amyloid PET Imaging Measures</hd> <p>PET data was used to quantify amyloid burden using Centiloid scale and amyloid status (positive or negative), which were provided to reflect the degree of degradation/amyloid plaque formation. PET data was acquired on a Bio-graph mMR hybrid scanner (Siemens Healthineers, Erlangen, Germany) with 18 F-florbetaben (Fodero-Tavoletti et al., [<reflink idref="bib27" id="ref122">27</reflink>]; Rowe et al., [<reflink idref="bib70" id="ref123">70</reflink>]). CapAIBL software (Bourgeat et al., [<reflink idref="bib14" id="ref124">14</reflink>]) was used to quantify images into Centiloids, wherein a Centiloid > 20 was classified as amyloid positive, whilst a Centiloid < 20 was classified as negative (Borne et al., [<reflink idref="bib13" id="ref125">13</reflink>]). These values were only available in our clinical groups.</p> <hd id="AN0186774307-17">Divergent thinking measures</hd> <p> <emph> <bold>Alternate Uses Task</bold> </emph> (AUT (Lezak, Howieson, Loring, Hannay, & Fischer, [<reflink idref="bib48" id="ref126">48</reflink>]; Robinson, Shallice, Bozzali, & Cipolotti, [<reflink idref="bib68" id="ref127">68</reflink>]). The AUT was used to measure divergent thinking (Batey, Chamorro-Premuzic, & Furnham, [<reflink idref="bib5" id="ref128">5</reflink>]; Benedek et al., [<reflink idref="bib8" id="ref129">8</reflink>]). Participants were required to orally generate as many uses as possible for two objects: (<reflink idref="bib1" id="ref130">1</reflink>) brick and (<reflink idref="bib2" id="ref131">2</reflink>) table knife, under two conditions: (<reflink idref="bib1" id="ref132">1</reflink>) conventional (e.g., brick: build a house, table knife: butter bread) and (<reflink idref="bib2" id="ref133">2</reflink>) unconventional uses (e.g., brick: paperweight, table knife: open letters). Ninety seconds were given to respond for each object per condition. Responses were scored as correct if it met the task condition (i.e., conventional use – conventional condition) and total correct was summed for the two objects in both conditions. Repetitions (perseverations) and rule-break errors (unconventional use – conventional condition) were excluded.</p> <p> <emph> <bold>Design Fluency</bold> </emph> (DFT; Jones-Gotman & Milner, [<reflink idref="bib37" id="ref134">37</reflink>]). Design fluency was used to assess nonverbal fluency. Participants are asked to generate as many abstract designs as possible that cannot be named in a given time in two conditions: (<reflink idref="bib1" id="ref135">1</reflink>) free – no constraints, 5 minutes; (<reflink idref="bib2" id="ref136">2</reflink>) fixed – using four lines, either all straight or all curved, 4 minutes. The total number of correct designs were tallied, excluding perseverations and rule-break errors (see (Robinson et al., [<reflink idref="bib69" id="ref137">69</reflink>]; Robinson, Shallice, Bozzali, & Cipolotti, [<reflink idref="bib68" id="ref138">68</reflink>]).</p> <hd id="AN0186774307-18">Convergent thinking measures</hd> <p></p> <hd id="AN0186774307-19">Remote Association Task</hd> <p>(RAT Mednick, [<reflink idref="bib58" id="ref139">58</reflink>]). The RAT was used to measure convergent thinking, wherein participants were required to find a word that could be associated with three seemingly unrelated words (e.g., cottage/swiss/cake are related to the word "cheese"). The number of correct responses were tallied to obtain a final score from a total of 15.</p> <hd id="AN0186774307-20">Anagrams</hd> <p>(Rees & Israel, [<reflink idref="bib66" id="ref140">66</reflink>]). This is a convergent thinking measure that involves rearranging scrambled letters to create a word (e.g., "IBKCR" can be rearranged to make "BRICK"). Participants are required to complete as many anagrams as possible within a five-minute timeframe. The number of correct responses were calculated, out of 10.</p> <hd id="AN0186774307-21">Statistical analyses</hd> <p>All analyses were conducted using the Statistical Package for the Social Sciences (SPSS), version 27.</p> <hd id="AN0186774307-22">Descriptive and cognitive baselines</hd> <p>The three participant groups (AD, MCI, and HC) were compared on demographic and cognitive baseline measures using a series of one-way Analysis of Variance (ANOVA). Significant results were followed up using Bonferroni-adjusted pairwise comparisons and independent samples t-tests.</p> <hd id="AN0186774307-23">Creativity</hd> <p>To explore aim 1, group differences on measures of verbal and non-verbal divergent and convergent thinking tasks were investigated with a series of one-way Analysis of Covariance (ANCOVA), with estimated level of premorbid intelligence (NART) entered as a covariate due to baseline group differences. Significant results were followed up using Bonferroni-adjusted pairwise comparisons and independent samples t-tests. Where assumptions for ANOVA were not met, non-parametric statistics were applied (i.e., Kruskal-Wallis tests, with significant results followed up with Mann-Whitney U tests).</p> <p>To investigate the relationship between verbal and nonverbal creativity tasks, Pearson's correlational analyses were conducted. Similarly, correlational analyses were conducted between creativity tasks and semantic knowledge/fluency tasks, and executive function tasks to explore additional cognitive processes that may contribute to creation of novel responses. We also explored correlations between the amyloid PET imaging measures and creativity tasks. Where assumptions for parametric correlational analyses were not met, nonparametric statistics were used (i.e., Kendall's Tau). A series of logistic regressions were performed to investigate whether performance upon a creativity task predicts clinical group.</p> <hd id="AN0186774307-24">Experiment 2</hd> <p></p> <hd id="AN0186774307-25">Participants</hd> <p>First-year psychology students (<emph>n</emph> = 146) aged 17–46 years (<emph>M</emph> = 19.88, <emph>SD</emph> = 3.87), comprising 27 males, 118 females, and one non-binary individual, were recruited from the University of Queensland via the online research participation system (SONA). Undergraduates acted as naïve raters in the study and were allocated 1 credit point upon completion of the SONA survey.</p> <hd id="AN0186774307-26">Procedure</hd> <p>The naïve raters were provided with instructions for the study, followed by demographic questions (age, sex, years of education), and then were shown collated AUT responses from the three participant groups. They were asked to group the responses according to four categories: (<reflink idref="bib1" id="ref141">1</reflink>) conventional, (<reflink idref="bib2" id="ref142">2</reflink>) unconventional but useful, (<reflink idref="bib3" id="ref143">3</reflink>) unconventional and bizarre, and (<reflink idref="bib4" id="ref144">4</reflink>) errors. Afterward, they were shown the collated OCT responses and asked to indicate whether the responses were common characteristics of the objects (yes versus no). Both the order of the responses and objects (e.g., brick, table knife) were randomized. Furthermore, as there were a large number of responses (AUT: 520 responses, OCT: 258 responses), the responses were randomly split into two datasets and randomly allocated to the raters (Set A: 78 raters, Set B: 68 raters). The datasets were matched for age, sex, and number of years of education. The ratings of the naïve raters were used as a manual to score all the AUT and OCT responses (Table 1). More specifically, based on the ratings of the naïve raters, the category with the highest percentage was chosen as a norm rating for each response. For instance, for the AUT, if 80% of the naïve raters rated "build a house" as a conventional use for brick, this response was categorized as a conventional use.</p> <hd id="AN0186774307-27">Statistical analyses</hd> <p>A 3 × 2 between-group Analysis of Covariance (ANCOVA) was conducted to examine the influence of the participant group on AUT scores, in both AUT conditions, when age and OCT scores were controlled for. Two ANCOVAs were conducted, using AUT scores obtained from the ratings of (<reflink idref="bib1" id="ref145">1</reflink>) neuropsychologists and (<reflink idref="bib2" id="ref146">2</reflink>) naïve raters. In both ANCOVAs, the two independent variables were group (healthy older controls, MCI, AD) and AUT condition (conventional, unconventional). The dependent variable was the AUT scores obtained from neuropsychologist/naïve raters ratings. Age and OCT scores obtained from neuropsychologist ratings were included as covariates to control for group differences, as significant group differences were found in earlier analyses. Significant results were followed up with pairwise comparisons (healthy older controls versus MCI, healthy older controls versus AD, MCI versus AD). Bonferroni-adjusted α level was used, and Cohen's kappa was utilized to explore inter-reliability.</p> <p>This project was approved by the University of Queensland Human Research Ethics Committee (2011000187). All participants provided informed written consent.</p> <hd id="AN0186774307-28">Results</hd> <p></p> <hd id="AN0186774307-29">Experiment 1</hd> <p></p> <hd id="AN0186774307-30">Missing data and normality</hd> <p>All tests were administered to the clinical participants (MCI, AD). Several HC participants did not complete the RAT, HSCT (initiation), RMT (faces and words), Design Fluency (free and fixed), and GNT. However, as the missing data from these measures was varied and inconsistent, these participants' data were retained for analysis.</p> <p>Outliers were detected for the HSCT (initiation), phonemic and semantic fluency tests, NART, RAVLT, AUT, Design Fluency, and RAT. However, outliers were retained for all analyses as they may reflect the true distribution of each participant groups' scores. Normality was measured via a Shapiro-Wilk test, which revealed violated normality for the HSCT, OCT, RAVLT, AUT (conventional, Design Fluency (fixed), and RAT. Therefore, further interpretation of these measures used non-parametric statistics.</p> <hd id="AN0186774307-31">Descriptive characteristics and baseline cognitive test summary</hd> <p>Descriptive characteristics and baseline cognitive test scores are presented in Table 2. The three groups were comparable for age, sex, and years of education (<emph>p</emph> >.05). One participant in our AD sample was amyloid negative, as were ten of our MCI sample. As expected, the AD group performed significantly worse than healthy controls (HC) on a number of cognitive baseline measures: premorbid functioning (NART), <emph>U</emph> = 203.00, <emph>z</emph> = −3.09, <emph>p</emph> <.01, naming (GNT), <emph>t</emph>(<reflink idref="bib33" id="ref147">33</reflink>) = 4.22, <emph>p</emph> <.001, semantic memory (OCT), <emph>U</emph> = 202.00, <emph>z</emph> = −3.12, <emph>p</emph> <.01, <emph>t</emph>(<reflink idref="bib31" id="ref148">31</reflink>) = 2.84, <emph>p</emph> <.01, verbal memory (RMT – Words), <emph>t</emph>(<reflink idref="bib51" id="ref149">51</reflink>) = 6.85, <emph>p</emph> <.001, initiation (HSCT), <emph>U</emph> = 205.50, <emph>z</emph> = −3.02, <emph>p</emph> <.01, phonemic fluency (FAS), <emph>t</emph>(<reflink idref="bib56" id="ref150">56</reflink>) = 6.27, <emph>p</emph> <.001, and semantic fluency (Animals), <emph>t</emph>(<reflink idref="bib56" id="ref151">56</reflink>) = 3.37, <emph>p</emph> <.001. The MCI group performed significantly worse than HC for naming (GNT), <emph>t</emph>(<reflink idref="bib32" id="ref152">32</reflink>) = 3.53, <emph>p</emph> <.001, verbal memory (RMT – Words), <emph>t</emph>(<reflink idref="bib52" id="ref153">52</reflink>) = 3.09, <emph>p</emph> <.01, suppression (HSCT), <emph>U</emph> = 244.50, <emph>z</emph> = −2.56, <emph>p</emph> <.01, and phonemic fluency (FAS), <emph>t</emph>(<reflink idref="bib56" id="ref154">56</reflink>) = 2.63, <emph>p</emph> <.01. When comparing the patient groups, the AD group performed significantly worse than the MCI group for verbal memory (RMT – Words), <emph>t</emph>(<reflink idref="bib39" id="ref155">39</reflink>) = 2.40, <emph>p</emph> <.01, <emph>p</emph> <.01, and phonemic fluency (FAS), <emph>t</emph>(<reflink idref="bib42" id="ref156">42</reflink>) = 3.86, <emph>p</emph> <.001. Centiloid was also significantly different between the two patient groups, <emph>t</emph>(<reflink idref="bib37" id="ref157">37</reflink>) = −2.46, <emph>p</emph> <.05.</p> <hd id="AN0186774307-32">Creativity tests</hd> <p>Due to the significant group difference found between the AD and HC groups on the NART, this variable was entered as a covariate in the following analyses.</p> <hd id="AN0186774307-33">Divergent thinking tasks</hd> <p>As shown in Table 3, the AD group performed significantly worse than HC on the AUT (conventional), <emph>U</emph> = 227.00, <emph>z</emph> = −2.72, <emph>p</emph> <.01, AUT (unconventional), <emph>U</emph> = 117.50, <emph>z</emph> = −4.47, <emph>p</emph> <.001, Design Fluency (free), <emph>U</emph> = 144.50, <emph>z</emph> = −2.68, <emph>p</emph> <.01, and Design Fluency (fixed), <emph>U</emph> = 31.50, <emph>z</emph> = −5.03, <emph>p</emph> <.001. The MCI group performed significantly worse than HC on the AUT (unconventional), <emph>U</emph> = 150.00, <emph>z</emph> = −3.96, <emph>p</emph> <.001. The AD group also performed significantly worse than the MCI group on Design Fluency (fixed), <emph>U</emph> = 87.00, <emph>z</emph> = −3.02, <emph>p</emph> <.01.</p> <p>Table 2. Cognitive baseline scores and demographic characteristics for healthy controls and patient groups (mean and standard deviation).</p> <p> <ephtml> <table><thead><tr><td /><td>HC</td><td>MCI</td><td>AD</td></tr></thead><tbody><tr><td /><td>n = 36</td><td>n = 22</td><td>n = 22</td></tr><tr><td><italic>Demographics</italic></td><td /><td /><td /></tr><tr><td>Sex (F:M)</td><td>(22:14)</td><td>(9:13)</td><td>(15:7)</td></tr><tr><td>Mean Age</td><td>68.5 (7.8)</td><td>66.9 (6.8)</td><td>63.9 (7.5)</td></tr><tr><td>Mean Education – years</td><td>14.0 (3.4)</td><td>12.9 (3.6)</td><td>13.5 (3.6)</td></tr><tr><td>Premorbid IQ (<p><graphic href="hcrj_a_2304498_ilm0001.gif" content-type="Graph" /><math xmlns="http://www.w3.org/1998/Math/MathML"><mrow xmlns=""><mrow><mi mathvariant="normal">NAR</mi></mrow></mrow><mrow xmlns=""><msup><mrow><mrow><mi mathvariant="normal">T</mi></mrow></mrow><mrow><mrow><mi mathvariant="normal">a</mi></mrow></mrow></msup></mrow></math></p>) Centiloid Amyloid Positive</td><td>113.3 (8.8)--</td><td>104.7 (10.4) 53.5 (48.5) 12/22</td><td><bold>101.6 (15.2)*</bold><bold>87.5 (35.6)^</bold> 21/22</td></tr><tr><td><italic>Language</italic></td><td /><td /><td /></tr><tr><td>Naming (<p><graphic href="hcrj_a_2304498_ilm0002.gif" content-type="Graph" /><math xmlns="http://www.w3.org/1998/Math/MathML"><mrow xmlns=""><mrow><mi mathvariant="normal">GN</mi></mrow></mrow><mrow xmlns=""><msup><mrow><mrow><mi mathvariant="normal">T</mi></mrow></mrow><mrow><mrow><mi mathvariant="normal">b</mi></mrow></mrow></msup></mrow></math></p>) (/30)</td><td>23.9 (3.4)</td><td><bold>18.4 (5.0)*</bold></td><td><bold>16.8 (5.4)*</bold></td></tr><tr><td><italic>Memory</italic></td><td /><td /><td /></tr><tr><td>Semantic (<p><graphic href="hcrj_a_2304498_ilm0003.gif" content-type="Graph" /><math xmlns="http://www.w3.org/1998/Math/MathML"><mrow xmlns=""><mrow><mi mathvariant="normal">OC</mi></mrow></mrow><mrow xmlns=""><msup><mrow><mrow><mi mathvariant="normal">T</mi></mrow></mrow><mrow><mrow><mi mathvariant="normal">c</mi></mrow></mrow></msup></mrow></math></p>)</td><td>9.4 (4.2)</td><td>7.0 (3.0)</td><td><bold>6.2 (3.6)*</bold></td></tr><tr><td>Visual (<p><graphic href="hcrj_a_2304498_ilm0004.gif" content-type="Graph" /><math xmlns="http://www.w3.org/1998/Math/MathML"><mrow xmlns=""><mrow><mi mathvariant="normal">RMT</mi></mrow></mrow><mo xmlns="">−</mo><mrow xmlns=""><mrow><mi mathvariant="normal">Face</mi></mrow></mrow><mrow xmlns=""><msup><mrow><mrow><mi mathvariant="normal">s</mi></mrow></mrow><mrow><mrow><mi mathvariant="normal">d</mi></mrow></mrow></msup></mrow></math></p>) (/50)</td><td>40.4 (2.8)</td><td>37.2 (5.9)</td><td>35.6 (6.9)</td></tr><tr><td>Verbal (<p><graphic href="hcrj_a_2304498_ilm0005.gif" content-type="Graph" /><math xmlns="http://www.w3.org/1998/Math/MathML"><mrow xmlns=""><mrow><mi mathvariant="normal">RMT</mi></mrow></mrow><mo xmlns="">−</mo><mrow xmlns=""><mrow><mi mathvariant="normal">Word</mi></mrow></mrow><mrow xmlns=""><msup><mrow><mrow><mi mathvariant="normal">s</mi></mrow></mrow><mrow><mrow><mi mathvariant="normal">e</mi></mrow></mrow></msup></mrow></math></p>) (/50)</td><td>45.2 (5.2)</td><td><bold>40.0 (7.2)*</bold></td><td><bold>32.4 (8.5)*^</bold></td></tr><tr><td><italic>Executive Functions</italic></td><td /><td /><td /></tr><tr><td>Initiation RT Scaled Score (<p><graphic href="hcrj_a_2304498_ilm0006.gif" content-type="Graph" /><math xmlns="http://www.w3.org/1998/Math/MathML"><mrow xmlns=""><mrow><mi mathvariant="normal">HSC</mi></mrow></mrow><mrow xmlns=""><msup><mrow><mrow><mi mathvariant="normal">T</mi></mrow></mrow><mrow><mrow><mi mathvariant="normal">f</mi></mrow></mrow></msup></mrow></math></p>)</td><td>5.6 (0.8)</td><td>5.1 (1.3)</td><td><bold>4.3 (1.8)*</bold></td></tr><tr><td>Suppression RT Scaled Score (<p><graphic href="hcrj_a_2304498_ilm0007.gif" content-type="Graph" /><math xmlns="http://www.w3.org/1998/Math/MathML"><mrow xmlns=""><mrow><mi mathvariant="normal">HSC</mi></mrow></mrow><mrow xmlns=""><msup><mrow><mrow><mi mathvariant="normal">T</mi></mrow></mrow><mrow><mrow><mi mathvariant="normal">f</mi></mrow></mrow></msup></mrow></math></p>)</td><td>5.5 (0.9)</td><td><bold>4.5 (1.6)*</bold></td><td>5.3 (1.1)</td></tr><tr><td>Global Error Score (<p><graphic href="hcrj_a_2304498_ilm0008.gif" content-type="Graph" /><math xmlns="http://www.w3.org/1998/Math/MathML"><mrow xmlns=""><mrow><mi mathvariant="normal">HSC</mi></mrow></mrow><mrow xmlns=""><msup><mrow><mrow><mi mathvariant="normal">T</mi></mrow></mrow><mrow><mrow><mi mathvariant="normal">f</mi></mrow></mrow></msup></mrow></math></p>)</td><td>-</td><td>10.5 (6.9)</td><td>9.6 (6.4)</td></tr><tr><td><italic>Fluency</italic></td><td /><td /><td /></tr><tr><td>Phonemic (FAS)</td><td>42.4 (10.6)</td><td><bold>34.2 (13.2)*</bold></td><td><bold>25.3 (9.3)*^</bold></td></tr><tr><td>Semantic (Animals)</td><td>18.1 (5.5)</td><td>16.5 (6.8)</td><td><bold>13.3 (4.8)*</bold></td></tr></tbody></table> </ephtml> </p> <p>1 Significant differences between clinical groups and HC are indicated in bold; *<emph>p</emph> <.05; Significant differences between MCI and AD group are denoted by "^."</p> <p>2</p> <p>Graph</p> <p> <ephtml> <math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><mrow><mi mathvariant="normal">NAR</mi></mrow></mrow><mrow><msup><mrow><mrow><mi mathvariant="normal">T</mi></mrow></mrow><mrow><mrow><mi mathvariant="normal">a</mi></mrow></mrow></msup></mrow></math> </ephtml> = National Adult Reading Test-2nd Ed (Nelson & Willison, [<reflink idref="bib60" id="ref158">60</reflink>]).</p> <p>3</p> <p>Graph</p> <p> <ephtml> <math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><mrow><mi mathvariant="normal">GN</mi></mrow></mrow><mrow><msup><mrow><mrow><mi mathvariant="normal">T</mi></mrow></mrow><mrow><mrow><mi mathvariant="normal">b</mi></mrow></mrow></msup></mrow></math> </ephtml> = Graded Naming Test (McKenna & Warrington, [<reflink idref="bib56" id="ref159">56</reflink>]).</p> <p>4</p> <p>Graph</p> <p> <ephtml> <math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><mrow><mi mathvariant="normal">OC</mi></mrow></mrow><mrow><msup><mrow><mrow><mi mathvariant="normal">T</mi></mrow></mrow><mrow><mrow><mi mathvariant="normal">c</mi></mrow></mrow></msup></mrow></math> </ephtml> = Object Characteristics Task (Fink et al., [<reflink idref="bib25" id="ref160">25</reflink>]).</p> <p>5</p> <p>Graph</p> <p> <ephtml> <math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><mrow><mi mathvariant="normal">RMT</mi></mrow></mrow><mo>−</mo><mrow><mrow><mi mathvariant="normal">Face</mi></mrow></mrow><mrow><msup><mrow><mrow><mi mathvariant="normal">s</mi></mrow></mrow><mrow><mrow><mi mathvariant="normal">d</mi></mrow></mrow></msup></mrow></math> </ephtml> = Recognition Memory Test-Faces (Warrington, [<reflink idref="bib81" id="ref161">81</reflink>]).</p> <p>6</p> <p>Graph</p> <p> <ephtml> <math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><mrow><mi mathvariant="normal">RMT</mi></mrow></mrow><mo>−</mo><mrow><mrow><mi mathvariant="normal">Word</mi></mrow></mrow><mrow><msup><mrow><mrow><mi mathvariant="normal">s</mi></mrow></mrow><mrow><mrow><mi mathvariant="normal">e</mi></mrow></mrow></msup></mrow></math> </ephtml> = Recognition Memory Test-Words (Warrington, [<reflink idref="bib81" id="ref162">81</reflink>]).</p> <p>7</p> <p>Graph</p> <p> <ephtml> <math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><mrow><mi mathvariant="normal">HSC</mi></mrow></mrow><mrow><msup><mrow><mrow><mi mathvariant="normal">T</mi></mrow></mrow><mrow><mrow><mi mathvariant="normal">f</mi></mrow></mrow></msup></mrow></math> </ephtml> = Hayling Sentence Completion Test (Burgess & Shallice, [<reflink idref="bib17" id="ref163">17</reflink>]).</p> <hd id="AN0186774307-34">Convergent thinking tasks</hd> <p>The AD group performed significantly worse compared to HC for the RAT, <emph>U</emph> = 22.00, <emph>z</emph> = −4.68, <emph>p</emph> <.001, and Anagrams, <emph>t</emph>(<reflink idref="bib48" id="ref164">48</reflink>) = 3.98, <emph>p</emph> <.001. The MCI group also performed significantly worse compared to HC on the RAT, <emph>U</emph> = 130.50, <emph>z</emph> = −3.58, <emph>p</emph> <.001, and Anagrams, <emph>t</emph>(<reflink idref="bib51" id="ref165">51</reflink>) = 3.41, <emph>p</emph> <.001.</p> <hd id="AN0186774307-35">Errors</hd> <p>The AD group made significantly more combined errors on the AUT than HC, <emph>U</emph> = 169.00, <emph>z</emph> = −3.67, <emph>p</emph> <.001. The AD group also made more percentage combined errors compared to HC on Design Fluency (fixed), <emph>U</emph> = 67.00, <emph>z</emph> = −4.33, <emph>p</emph> <.001. While the AD group did not make more errors on the RAT than HC, they did make more errors compared to the MCI group on the RAT, <emph>U</emph> = 56.50, <emph>z</emph> = −2.91, <emph>p</emph> <.01, and on combined Design Fluency (fixed) errors, <emph>U</emph> = 98.00, <emph>z</emph> = −2.72, <emph>p</emph> <.01. The MCI group made significantly more errors than HC on Design Fluency (free – combined errors), <emph>U</emph> = 229.50, <emph>z</emph> = −2.71, <emph>p</emph> <.01, and Design Fluency (free – perseverative errors), <emph>U</emph> = 242.00, <emph>z</emph> = −2.47, <emph>p</emph> <.05.</p> <hd id="AN0186774307-36">Prediction analyses</hd> <p></p> <hd id="AN0186774307-37">Divergent thinking tasks</hd> <p>Performance on the AUT (conventional) was found to predict overall clinical group membership,</p> <p>Graph</p> <p> <ephtml> <math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><msup><mrow><mrow><mi mathvariant="normal">X</mi></mrow></mrow><mn>2</mn></msup></mrow></math> </ephtml> = 8.13, <emph>p</emph> =.321, correctly classifying 60% of participants, and was able to predict MCI group, correctly classifying 52% of participants. Performance on the AUT (unconventional) was also found to predict clinical group membership,</p> <p>Graph</p> <p> <ephtml> <math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><msup><mrow><mrow><mi mathvariant="normal">X</mi></mrow></mrow><mn>2</mn></msup></mrow></math> </ephtml> = 11.26, <emph>p</emph> <.001, and was able to correctly classify 78% of participants. AUT (unconventional) predicted MCI group, classifying 57% of participants.</p> <p>Design Fluency (free) scores were able to predict overall clinical group membership,</p> <p>Graph</p> <p> <ephtml> <math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><msup><mrow><mrow><mi mathvariant="normal">X</mi></mrow></mrow><mn>2</mn></msup></mrow></math> </ephtml> = 10.85, <emph>p</emph> =.210, correctly classifying 70% of participants, as did Design Fluency (fixed),</p> <p>Graph</p> <p> <ephtml> <math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><msup><mrow><mrow><mi mathvariant="normal">X</mi></mrow></mrow><mn>2</mn></msup></mrow></math> </ephtml> = 16.33, <emph>p</emph> <.05, which classified 77% of participants. Design Fluency (free) correctly predicted MCI group, classifying 65% of participants, as did Design Fluency (fixed), correctly classifying 75% of participants.</p> <hd id="AN0186774307-38">Convergent thinking tasks</hd> <p>Performance on the RAT was found to predict clinical group membership,</p> <p>Graph</p> <p> <ephtml> <math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><msup><mrow><mrow><mi mathvariant="normal">X</mi></mrow></mrow><mn>2</mn></msup></mrow></math> </ephtml> = 6.70, <emph>p</emph> =.570, correctly classifying 82% of participants. The RAT was able to predict MCI group, correctly classifying 49% of participants.</p> <p>Performance on Anagrams also predicted overall clinical group membership,</p> <p>Graph</p> <p> <ephtml> <math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><msup><mrow><mrow><mi mathvariant="normal">X</mi></mrow></mrow><mn>2</mn></msup></mrow></math> </ephtml> = 1.97, <emph>p</emph> =.961, correctly classifying 71% of participants, and was able to predict MCI group, correctly classifying 49% of participants.</p> <hd id="AN0186774307-39">Relationships between creativity tests and cognitive measures</hd> <p>To explore the relationship between verbal and non-verbal creative thought tasks and explore the cognitive processes that may contribute, a Pearson's correlation was conducted, incorporating all participants (see Table 4). Kendall's Tau was utilized when non-parametric statistics were required.</p> <p>Table 3. Creativity task performance for healthy controls and patient groups (mean and standard error).</p> <p> <ephtml> <table><thead><tr><td /><td>HC</td><td>MCI</td><td>AD</td></tr></thead><tbody><tr><td /><td>n = 36</td><td>n = 22</td><td>n = 22</td></tr><tr><td><italic>Divergent Thinking</italic></td><td /><td /><td /></tr><tr><td>Alternate Uses Task</td><td /><td /><td /></tr><tr><td>Conventional (# Generated)</td><td>12.1 (5.2)</td><td>10.5 (5.0)</td><td><bold>8.5 (3.4)*</bold></td></tr><tr><td>Unconventional (# Generated)</td><td>12.3 (4.8)</td><td><bold>7.1 (3.0)*</bold></td><td><bold>5.8 (3.2)*</bold></td></tr><tr><td>Combined # Errors</td><td>2.9 (3.4)</td><td>4.8 (2.7)</td><td><bold>7.3 (6.7)*</bold></td></tr><tr><td>Design Fluency</td><td /><td /><td /></tr><tr><td>Free (# Generated)</td><td>24.1 (11.7)</td><td>19.5 (9.3)</td><td><bold>15.9 (9.3)*</bold></td></tr><tr><td>Free (% Combined Errors)</td><td>0.6 (2.6)</td><td><bold>7.3 (13.5)*</bold></td><td>5.0 (7.8)</td></tr><tr><td>Free (% Perseverative Errors)</td><td>0.5 (1.9)</td><td><bold>4.5 (7.8)*</bold></td><td>3.2 (7.0)</td></tr><tr><td>Fixed (# Generated)</td><td>23.8 (5.8)</td><td>18.8 (9.5)</td><td><bold>9.8 (6.5)*^</bold></td></tr><tr><td>Fixed (% Combined Errors)</td><td>6.2 (10.3)</td><td>13.3 (13.9)</td><td><bold>32.9 (24.9)*^</bold></td></tr><tr><td>Fixed (% Perseverative Errors)</td><td>3.0 (5.3)</td><td>3.2 (5.8)</td><td>4.9 (9.4)</td></tr><tr><td><italic>Convergent Thinking</italic></td><td /><td /><td /></tr><tr><td>Remote Associates (/15)</td><td>8.9 (3.2)</td><td><bold>4.7 (3.9)*</bold></td><td><bold>3.1 (1.8)*</bold></td></tr><tr><td># Errors</td><td>0.7 (0.9)</td><td>0.5 (0.8)</td><td><bold>2.5 (3.5)^</bold></td></tr><tr><td>Anagrams (/10)</td><td>7.4 (2.4)</td><td><bold>4.9 (2.8)*</bold></td><td><bold>4.6 (2.4)*</bold></td></tr><tr><td># Errors</td><td>0.7 (0.8)</td><td>0.7 (0.7)</td><td>1.0 (1.1)</td></tr></tbody></table> </ephtml> </p> <p>8 Significant differences between clinical groups and HC are indicated in bold; *<emph>p</emph> <.05; Significant differences between MCI and AD group are denoted by "^."</p> <p>Table 4. Correlations (<emph>r</emph> and <emph>τ</emph><subs>b</subs>) between all creativity tasks, clinical group, and measures of semantic memory/fluency and executive functions.</p> <p> <ephtml> <table><thead><tr><td /><td>AUT Conv</td><td>AUT Unco</td><td>DF Free</td><td>DF Fixed</td><td>RAT</td><td>Anagrams</td><td>OCT</td><td>HSCT – Ini</td><td>HSCT – Supp</td><td>HSCT – Global Err</td><td>Phonemic Fluency</td><td>Semantic Fluency</td><td>Centiloid</td></tr></thead><tbody><tr><td>AUT Conv</td><td /><td>.<bold>251**</bold></td><td>.022</td><td>.<bold>240**</bold></td><td>.174</td><td>.<bold>190*</bold></td><td>.<bold>275**</bold></td><td>−.009</td><td>−.202</td><td>−.060</td><td>.<bold>253**</bold></td><td>.<bold>177*</bold></td><td>.029</td></tr><tr><td>AUT Unco</td><td /><td /><td>.<bold>312**</bold></td><td>.<bold>491**</bold></td><td>.<bold>340**</bold></td><td>.<bold>309**</bold></td><td>.<bold>239**</bold></td><td>.006</td><td>−.106</td><td>−.192</td><td>.<bold>378**</bold></td><td>.<bold>271**</bold></td><td>−.131</td></tr><tr><td>DF Free</td><td /><td /><td /><td>.<bold>326**</bold></td><td>.029</td><td>.017</td><td>.158</td><td>−.124</td><td>−.163</td><td><bold>−.264*</bold></td><td>.<bold>182*</bold></td><td>.014</td><td>−.076</td></tr><tr><td>DF Fixed</td><td /><td /><td /><td /><td>.<bold>306**</bold></td><td>.<bold>309*</bold></td><td>.<bold>314**</bold></td><td><bold>−.296**</bold></td><td>−.132</td><td><bold>−.306**</bold></td><td>.<bold>438**</bold></td><td>.<bold>293**</bold></td><td><bold>−.237*</bold></td></tr><tr><td>RAT</td><td /><td /><td /><td /><td /><td>.<bold>475**</bold></td><td>.<bold>185*</bold></td><td>−.222</td><td>−.129</td><td>.014</td><td>.<bold>361**</bold></td><td>.<bold>288**</bold></td><td>.078</td></tr><tr><td>Anagrams</td><td /><td /><td /><td /><td /><td /><td>.214</td><td>−.300</td><td><bold>−.360*</bold></td><td>−.137</td><td>.<bold>539**</bold></td><td>.<bold>398**</bold></td><td>.324</td></tr><tr><td>OCT</td><td /><td /><td /><td /><td /><td /><td /><td><bold>−.307*</bold></td><td>−.070</td><td>.012</td><td>.<bold>420**</bold></td><td>.<bold>330**</bold></td><td>.077</td></tr><tr><td>HSCT – Ini</td><td /><td /><td /><td /><td /><td /><td /><td /><td>.<bold>275**</bold></td><td>−.019</td><td><bold>−.258*</bold></td><td><bold>−.375**</bold></td><td>.038</td></tr><tr><td>HSCT – Supp</td><td /><td /><td /><td /><td /><td /><td /><td /><td /><td>.<bold>294**</bold></td><td>−.200</td><td>−.121</td><td><bold>−.229*</bold></td></tr><tr><td>HSCT – Global Err</td><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td>.073</td><td>.160</td><td>−.111</td></tr><tr><td>Phonemic</td><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td>.<bold>506**</bold></td><td>.240</td></tr><tr><td>Semantic</td><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td>−.075</td></tr><tr><td>Centiloid</td><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td>-</td></tr></tbody></table> </ephtml> </p> <p>9 The correlations provided for the AUT (conventional), DF (fixed), RAT, and HSCT (initiation RT, suppression RT, and global error score) are Kendall's Tau, non-parametric statistics. *<emph>p</emph> <.05, **<emph>p</emph> <.001.</p> <p>The AUT (conventional) showed significant positive relationships with the AUT (unconventional), Design Fluency (fixed), Anagrams, the OCT, and phonemic and semantic fluency. The AUT (unconventional) demonstrated significant positive relationships with Design Fluency (free and fixed), the RAT, Anagrams, the OCT, and phonemic and semantic fluency. Design Fluency (free) additionally showed positive relationships with Design Fluency (fixed) and phonemic fluency, and a negative relationship with the HSCT global error score. Design Fluency (fixed) was revealed to have additional positive associations with the RAT, Anagrams, the OCT, and phonemic and semantic fluency, and negative associations with the HSCT initiation score, HSCT global error score, and Centiloid. Further, the RAT demonstrated significant positive correlations with Anagrams, the OCT, and phonemic and semantic fluency, whilst Anagrams revealed significant positive relationships with phonemic and semantic fluency, and negative associations with the HSCT suppression score. Centiloid was additionally negatively correlated with the HSCT suppression score.</p> <hd id="AN0186774307-40">Experiment 2</hd> <p></p> <hd id="AN0186774307-41">Normality</hd> <p>Normality, linearity, and homogeneity of variance were examined, revealing a positive skew for the AUT scored by both neuropsychologists and naïve raters. To correct for violations in the assumptions, the data were square-root transformed. No violations of normality and homogeneity of variance occurred after the transformation, therefore further interpretations used parametric data.</p> <hd id="AN0186774307-42">AUT scored by neuropsychologists</hd> <p>After controlling for age and OCT scores, a significant main effect of AUT condition for AUT scores was found, <emph>F</emph>(<reflink idref="bib1" id="ref166">1</reflink>,<reflink idref="bib104" id="ref167">104</reflink>) = 6.35, <emph>p</emph> =.013, indicating that the participants generated a significantly higher number of AUT responses in the conventional than the unconventional condition (Table 5). A significant main effect of participant group for AUT scores was also found, <emph>F</emph>(<reflink idref="bib2" id="ref168">2</reflink>,<reflink idref="bib104" id="ref169">104</reflink>) = 8.44, <emph>p</emph> <.001. This was followed up with Bonferroni adjusted pairwise comparisons, which indicated that the healthy older controls generated a significantly higher number of AUT responses than the MCI and AD group, <emph>t</emph>(<reflink idref="bib104" id="ref170">104</reflink>) = 3.23, <emph>p</emph> =.002 and <emph>t</emph>(<reflink idref="bib104" id="ref171">104</reflink>) = 3.96, <emph>p</emph> <.001, respectively. In contrast, there were no significant differences in the number of AUT responses generated between the MCI and AD group, <emph>t</emph>(<reflink idref="bib104" id="ref172">104</reflink>) = 1.74, <emph>p</emph> =.086. There were no significant interactions between the participant group and AUT condition, <emph>F</emph>(<reflink idref="bib2" id="ref173">2</reflink>,<reflink idref="bib104" id="ref174">104</reflink>) = 1.23, <emph>p</emph> =.297.</p> <p>Table 5. AUT scores rated by neuropsychologists and naïve raters for healthy older controls, mild cognitive impairment, Alzheimer's disease, with means and standard deviations.</p> <p> <ephtml> <table><thead><tr><td>Variable</td><td>Condition</td><td>Participant Group</td></tr></thead><tbody><tr><td /><td /><td>Healthy Older Controls</td><td>Mild Cognitive Impairment</td><td>Alzheimer's Disease</td></tr><tr><td /><td /><td><italic>M</italic></td><td><italic>SD</italic></td><td><italic>M</italic></td><td><italic>SD</italic></td><td><italic>M</italic></td><td><italic>SD</italic></td></tr><tr><td>AUTNeuro</td><td>Conventional</td><td>13.23</td><td>5.33</td><td>9.50</td><td>2.83</td><td>8.07</td><td>3.43</td></tr><tr><td>Unconventional</td><td>12.58</td><td>4.54</td><td>7.63</td><td>3.46</td><td>5.64</td><td>3.20</td></tr><tr><td>AUTSONA</td><td>Conventional</td><td>13.04</td><td>5.07</td><td>9.19</td><td>2.34</td><td>8.36</td><td>3.34</td></tr><tr><td>Unconventional</td><td>11.38</td><td>4.67</td><td>6.81</td><td>3.35</td><td>6.29</td><td>3.29</td></tr></tbody></table> </ephtml> </p> <p>10 AUTNeuro refers to the AUT scores obtained from the ratings of the neuropsychologists, while AUTSONA refers to the AUT scores obtained from the ratings of the naïve raters.</p> <hd id="AN0186774307-43">AUT scored by naïve raters</hd> <p>After controlling for age and OCT scores, a significant main effect of AUT condition for AUT scores was found, <emph>F</emph>(<reflink idref="bib1" id="ref175">1</reflink>,<reflink idref="bib104" id="ref176">104</reflink>) = 9.59, <emph>p</emph> =.003, indicating that participants generated a significantly higher number of AUT responses in the conventional than the unconventional condition. A significant main effect of participant group for AUT scores was also found, <emph>F</emph>(<reflink idref="bib2" id="ref177">2</reflink>,<reflink idref="bib104" id="ref178">104</reflink>) = 5.35, <emph>p</emph> =.006. Follow-up comparisons indicated that the healthy older controls generated a significantly higher number of AUT responses than the MCI and AD group, <emph>t</emph>(<reflink idref="bib104" id="ref179">104</reflink>) = 3.10, <emph>p</emph> =.002 and <emph>t</emph>(<reflink idref="bib53" id="ref180">53</reflink>) = 2.69, <emph>p</emph> =.009, respectively. There were no significant differences in the number of AUT responses generated between the MCI and AD group, <emph>t</emph>(<reflink idref="bib104" id="ref181">104</reflink>) =.29, <emph>p</emph> =.774. There were no significant interactions between the participant group and AUT condition, <emph>F</emph>(<reflink idref="bib2" id="ref182">2</reflink>,<reflink idref="bib104" id="ref183">104</reflink>) = 0.38, <emph>p</emph> =.684.</p> <hd id="AN0186774307-44">Inter-rater reliability</hd> <p>The inter-rater reliability was interpreted using the Cohen Kappa correlation coefficient (McHugh, [<reflink idref="bib55" id="ref184">55</reflink>]). A significant weak inter-rater reliability was found between the OCT ratings of the neuropsychologists and naïve raters, κ =.46, <emph>p</emph> <.001. A significant moderate inter-rater reliability was found between the AUT ratings of the neuropsychologists and naïve raters, κ =.75, <emph>p</emph> <.001.</p> <hd id="AN0186774307-45">Discussion</hd> <p>The present study investigated patterns of creativity between healthy older controls, and adults with MCI or AD, exploring the underlying cognitive processes contributing to creative thought, and whether performance on a creativity task can predict clinical group membership. To the best of our knowledge, this is the first study that has observed patterns of creativity within individuals with MCI. As expected, it was found that the AD group generated the lowest number of correct responses on all creative thought measures and made the most errors across divergent and convergent thinking tasks. We also found that performance on select creativity tasks could predict clinical group membership, including the MCI group. Finally, our findings suggested some cognitive processes that underlie creative thought, including semantic knowledge/memory and executive functions. The results were not attributable to differences in age or sex.</p> <p>Regarding Experiment 2, it was hypothesized that the ratings of the neuropsychologists and naïve raters would not be different for both the conventional and unconventional conditions. Consistent with the hypothesis, the AUT ratings of the neuropsychologists and naïve raters did not differ. Moreover, a moderate level of agreement was found between the two groups of raters. This demonstrates that there is little variance in the interpretation of the terms "conventional" and "unconventional," such that the definition of the two terms is obvious even to untrained naïve raters. This may indicate that a scoring manual for the AUT is unnecessary.</p> <hd id="AN0186774307-46">Divergent and convergent thinking tasks</hd> <p>The AD group experienced the greatest impairment in both divergent and convergent thinking tasks, supporting previous findings that as dementia progresses, the ability to think creatively and produce new ideas decreases (Palmiero, Di Giacomo, & Passafiume, [<reflink idref="bib61" id="ref185">61</reflink>]). Our response generation results demonstrate that all creative thought tasks show sensitivity to AD and that Design Fluency (fixed) shows specificity to AD, as the AD group was significantly impaired compared to the MCI group. Overall, the impairment in both divergent and convergent thinking in the AD group may relate to both medial and anterior temporal and prefrontal cortex dysfunction relevant to AD progression, wherein deterioration in semantic memory, abstract thinking, fluency, and executive control are characteristic of the disease (Fuster, [<reflink idref="bib30" id="ref186">30</reflink>]; Hart & Wade, [<reflink idref="bib35" id="ref187">35</reflink>]). In particular, fluency tasks such as ideational fluency and Design Fluency have been associated with the frontotemporal regions and have been found to be sensitive to frontal lobe damage (Baldo, Schwartz, Wilkins, & Dronkers, [<reflink idref="bib4" id="ref188">4</reflink>]; Robinson et al., [<reflink idref="bib69" id="ref189">69</reflink>]; Robinson, Shallice, Bozzali, & Cipolotti, [<reflink idref="bib68" id="ref190">68</reflink>]).</p> <p>Notably, the MCI group's performance was reduced on the AUT (unconventional),the RAT, and Anagrams. The AUT requires fluent generation of appropriate and novel responses to a single cue and is reliant upon several processes including access to and retrieval of stored knowledge (i.e., semantic and personal memories), initiation and energization, response monitoring to inhibit inappropriate responses, and effective task-setting. The AUT (unconventional) places high emphasis on the generation of <emph>novel</emph> responses and processes, which implies that those within the MCI group show reduced novel problem-solving abilities and divergent thinking. By contrast, the RAT and Anagrams require a degree of focus and ongoing persistence to find single solutions, as well as combining of remotely associated concepts from lexical-semantic networks to generate a novel combination (Mednick, [<reflink idref="bib58" id="ref191">58</reflink>]). The RAT also involves an element of task-setting to establish a stimulus-response relationship, strategic retrieval of stored items, and analytical, deductive processing (including fluid intelligence) (Lee, Huggins, & Therriault, [<reflink idref="bib47" id="ref192">47</reflink>]). As such, we can infer that the MCI group show a steeper associative hierarchy (and therefore generated a smaller variety of associative responses to cued words), but also reduced deductive and semantic processing, and convergent thinking (Marko, Michalko, & Riečanský, [<reflink idref="bib52" id="ref193">52</reflink>]).</p> <p>The MCI group did not differ from healthy controls on the AUT (conventional), indicating that they can perform comparably to healthy controls on tasks with reduced constraint and decreased requirements for novel idea generation (i.e., their retrieval of stored representations is intact) (Robinson et al., [<reflink idref="bib69" id="ref194">69</reflink>]). It is common for patients with frontal damage to experience impairment in non-verbal fluency measures (i.e., Design Fluency) due to the demand on novel response creation; however, the MCI group did not demonstrate reduced performance on these tasks (Robinson et al., [<reflink idref="bib69" id="ref195">69</reflink>]). Therefore, it is possible that this negative result reflects the lack of profound prefrontal dysfunction found within the less severe disease stage of MCI.</p> <p>The AD group produced a higher percentage of combined (rule-break and perseverative) errors in all divergent thinking tasks excluding Design Fluency (free). This result partially aligns with prior findings revealing that tasks which place a high demand on novelty processes correspond with high error rates within frontal damage patients (Robinson et al., [<reflink idref="bib69" id="ref196">69</reflink>]). However, the lack of an effect within the AD group on Design Fluency (free) is somewhat unusual, given that perseverative and rule-break errors are common amongst patients with prefrontal dysfunction (Foldi, Helm-Estabrooks, Redfield, & Nickel, [<reflink idref="bib28" id="ref197">28</reflink>]). That being said, the AD group did produce more combined errors on Design Fluency (fixed), which may relate to an increased requirement for strategic processes and adherence to higher task constraints in comparison to the free task condition.</p> <p>The AD group also produced more errors upon the RAT and Design Fluency (fixed) than the MCI group. This result could be attributable to impaired verbal intelligence in our AD sample, including reading, naming, and semantic memory, which has been shown to be predictive of convergent thinking abilities and insight problem solving (DeYoung, Flanders, & Peterson, [<reflink idref="bib21" id="ref198">21</reflink>]). A loosely structured stored knowledge base (i.e., semantic knowledge) has been emphasized as an important skill for facilitating and organizing creative ideas, as is fluency (Hull, [<reflink idref="bib36" id="ref199">36</reflink>]; Mednick, [<reflink idref="bib58" id="ref200">58</reflink>]); all of which were reduced in our AD sample. This may suggest that semantic memory and naming play a key role in creative performance, as measured by the RAT. The MCI group differed from healthy controls only in the number of combined and perseverative errors produced on Design Fluency (free). The MCI group did not have reduced crystallized intelligence abilities or semantic knowledge, which again may indicate that this result is a reflection of more intact prefrontal functioning suggestive of less severe disease progression. However, they did have significantly reduced inhibition abilities as measured by the HSCT, which may imply that reduced abilities in inhibition result in increased perseveration and errors on a task with less constraints (i.e., as compared to Design Fluency (fixed)).</p> <hd id="AN0186774307-47">Predicting clinical group from creative performance</hd> <p>All convergent and divergent thinking creativity tasks were able to predict MCI group membership, indicating that the measures used can discriminate MCI, AD, and healthy older adults (and some between mild and severe dementia-related impairments). When combined with group difference results, it is apparent that Design Fluency (fixed) and the RAT in particular show specificity to AD in comparison to MCI. Once again, this indicates that poor performance on measures of creative thought may be a sign of mild dementia symptoms, and provides a means for early identification of individuals at risk of AD. Given the benefits of creativity in older adults, and the early impairments in creativity in the AD and MCI groups, early psychological interventions in the form of rehabilitation programs aimed to maintain or enhance cognitive abilities should focus on better accessing the semantic knowledge base or minimizing decline in executive functions (Batey, Chamorro-Premuzic, & Furnham, [<reflink idref="bib5" id="ref201">5</reflink>]).</p> <hd id="AN0186774307-48">Relationship between creativity tasks and cognitive processes</hd> <p>The association between semantic knowledge/memory and creativity tasks was unsurprising, given the function of the semantic network in ensuring task-relevant meaningful representations are produced in response to creativity measures. A possible factor underlying this relationship in divergent thinking tasks is the fluency and flexibility of thought that is necessary for performing well on these tasks. When providing novel responses in divergent tasks, performance is reliant on the ability to access, search, and retrieve stored knowledge, as well as produce responses that are appropriate and different from those given previously (Beaty et al., [<reflink idref="bib6" id="ref202">6</reflink>]; Turner, [<reflink idref="bib77" id="ref203">77</reflink>]). Connecting distal concepts in loosely structured semantic networks is crucial for generating more novel, original responses to the questions asked, highlighting the value of a wide semantic network in divergent thinking (Webb, Little, Cropper, & Roze, [<reflink idref="bib83" id="ref204">83</reflink>]). Similarly, convergent thinking has a strong emphasis on semantic memory and language, where it is important to approach the problems with a less rigid semantic network (Christensen, Kenett, Cotter, Beaty, & Silvia, [<reflink idref="bib19" id="ref205">19</reflink>]). Our findings reflect that of previous research, where performance on convergent tasks reflects strong lexical-semantic network connectivity and semantic processing over and above executive processes (Marko, Michalko, & Riečanský, [<reflink idref="bib52" id="ref206">52</reflink>]).</p> <p>Regarding fluency, both the phonemic and semantic fluency tasks were positively related with all measures of convergent and divergent thinking. Fluency tasks require initiation and energization across a period of time, selection of ideas amongst competing words, and the ability to inhibit responding at the end of the time period (Robinson et al., [<reflink idref="bib69" id="ref207">69</reflink>]; Stuss & Alexander, [<reflink idref="bib75" id="ref208">75</reflink>]). These tasks also require retrieval from semantic memory, processing speed, and sustained attention (Hull, [<reflink idref="bib36" id="ref209">36</reflink>]). Therefore, it can be taken that executive functions underpin the generation of novel responses and the use of strategic processes to complete divergent and convergent thought tasks, such that those with increased executive capacity are better able to initiate and sustain responding, switch strategies and monitor their ideas, and resist intrusions (Gilhooly, Fioratou, Anthony, & Wynn, [<reflink idref="bib33" id="ref210">33</reflink>]).</p> <p>Our findings demonstrate that when considering the reaction time taken to inhibit a pre-potent response, suppression is only negatively related to performance on Anagrams. However, it was revealed that persons who generated more errors in their responses to the task (i.e., they failed to inhibit a pre-potent response) performed worse on our measures of divergent thinking. As such, the participants were able to respond quickly to the prompt but were unable to inhibit their responses to provide a correct answer. The AUT (unconventional) and Design Fluency tasks place great demand on production of novel responses, whereas the AUT (conventional) and convergent thinking tasks such as the RAT and Anagrams rely more on retrieval of stored representations (Robinson et al., [<reflink idref="bib69" id="ref211">69</reflink>]). Thus, it can be concluded that if an individual has difficulties inhibiting automatic responses, they will generate fewer responses to prompts demanding originality and novelty. In agreement with prior research, our findings revealed that generating responses on convergent thinking tasks does not involve suppression of a pre-potent response (Marko, Michalko, & Riečanský, [<reflink idref="bib52" id="ref212">52</reflink>]). This does not necessarily mean that convergent tasks do not require any executive involvement, but rather that other factors are more critical for adequate performance, including retrieval of stored representations and use of the semantic knowledge base. Initiation was found to be associated with Design Fluency (fixed), which supports that idea that sustaining responding in the absence of a cue is important for non-verbal, high constraint divergent thinking tasks.</p> <hd id="AN0186774307-49">Conclusion</hd> <p>Overall, our findings suggest that both divergent and convergent thought are reduced in individuals with AD and MCI. While the AD group demonstrated reduced performance across all tasks, the MCI group only performed worse than healthy older adults on the AUT (unconventional) and RAT. The AD group also produced a higher percentage of combined errors on all divergent thinking tasks and the RAT, which is likely reflective of difficulties with strategic processing, novel problem solving, impaired verbal and crystallized intelligence, and reduced self-monitoring. The MCI group did not produce more errors, which may reflect less severe disease progression and suggest that creative thought tasks are sensitive to more profound prefrontal dysfunction. Across all creative thought tasks, performance was found to predict MCI group membership, with Design Fluency (fixed) and the RAT showing specificity to AD. Finally, our results provide evidence that semantic memory, novel response generation, strategic processes, the ability to access and retrieve stored items via strategic processes, and executive functions such as initiation, energization, monitoring, selection, inhibition, and suppression of pre-potent responses all play critical roles in divergent and convergent thought.</p> <hd id="AN0186774307-50">Acknowledgments</hd> <p>We would like to thank the patients and families who gave us their time for this study. The Prospective Imaging Study of Ageing: Genes, Brain and Behaviour (PISA) is funded by a National Health and Medical Research Council (NHMRC) Boosting Dementia Research Initiative - Team Grant [APP1095227]. This study was supported a NHMRC Boosting Dementia Research Leadership Fellowship (APP1135769) awarded to GAR, and in part by the Brazil Family Program for Neurology.</p> <hd id="AN0186774307-51">Disclosure statement</hd> <p>No potential conflict of interest was reported by the author(s).</p> <ref id="AN0186774307-52"> <title> References </title> <blist> <bibl id="bib1" idref="ref25" type="bt">1</bibl> <bibtext> Albert, M. S., DeKosky, S. T., Dickson, D., Dubois, B., Feldman, H. H. ... Phelps, C. H. (2011). The diagnosis of mild cognitive impairment due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & Dementia, 7 (3), 270 – 279. doi: 10.1016/j.jalz.2011.03.008</bibtext> </blist> <blist> <bibl id="bib2" idref="ref26" type="bt">2</bibl> <bibtext> Alfonso-Benlliure, V., Mayordomo, T., Sales, A., & Mélendez, J. C. (2021). Divergent thinking in older adults: Understanding its role in well-being. Journal of Happiness Studies, 22 (7), 3285 – 3298. doi: 10.1007/s10902-021-00361-w</bibtext> </blist> <blist> <bibl id="bib3" idref="ref6" type="bt">3</bibl> <bibtext> Baas, M., De Dreu, C. K. W., & Nijstad, B. A. (2015). The cognitive, emotional and neural correlates of creativity. Frontiers in Human Neuroscience, 9, 275.</bibtext> </blist> <blist> <bibl id="bib4" idref="ref104" type="bt">4</bibl> <bibtext> Baldo, J. V., Schwartz, S., Wilkins, D., & Dronkers, N. F. (2006). Role of frontal versus temporal cortex in verbal fluency as revealed by voxel-based lesion symptom mapping. Journal of the International Neuropsychological Society: JINS, 12 (6), 896 – 900. doi: 10.1017/S1355617706061078</bibtext> </blist> <blist> <bibl id="bib5" idref="ref128" type="bt">5</bibl> <bibtext> Batey, M., Chamorro-Premuzic, T., & Furnham, A. (2009). Intelligence and personality as predictors of divergent thinking: The role of general, fluid and crystallised intelligence. Thinking Skills and Creativity, 4 (1), 60 – 69. doi: 10.1016/j.tsc.2009.01.002</bibtext> </blist> <blist> <bibl id="bib6" idref="ref20" type="bt">6</bibl> <bibtext> Beaty, R. E., Benedek, M., Wilkins, R. W., Jauk, E., Fink, A. ... Neubauer, A. C. (2014). Creativity and the default network: A functional connectivity analysis of the creative brain at rest. Neuropsychologia, 64, 92 – 98. doi: 10.1016/j.neuropsychologia.2014.09.019</bibtext> </blist> <blist> <bibl id="bib7" idref="ref1" type="bt">7</bibl> <bibtext> Bellass, S., Balmer, A., May, V., Keady, J., Buse, C. ... Hodgson, J. (2019). Broadening the debate on creativity and dementia: A critical approach. Dementia (London, England), 18 (7–8), 2799 – 2820. doi: 10.1177/1471301218760906</bibtext> </blist> <blist> <bibl id="bib8" idref="ref129" type="bt">8</bibl> <bibtext> Benedek, M., Franz, F., Heene, M., & Neubauer, A. C. (2012). Differential effects of cognitive inhibition and intelligence on creativity. Personality & Individual Differences, 53 (4), 480 – 485. https://doi.org/10.1016/j.paid.2012.04.014</bibtext> </blist> <blist> <bibl id="bib9" idref="ref120" type="bt">9</bibl> <bibtext> Benton, A. L. (1968). Differential behavioral effects in frontal lobe disease. Neuropsychologia, 6 (1), 53 – 60. doi: 10.1016/0028-3932(68)90038-9</bibtext> </blist> <blist> <bibtext> Bettio, L. E. B., Rajendran, L., & Gil-Mohapel, J. (2017). The effects of aging in the hippocampus and cognitive decline. Neuroscience and Biobehavioral Reviews, 79, 66 – 86. doi: 10.1016/j.neubiorev.2017.04.030</bibtext> </blist> <blist> <bibtext> Bigler, E. D. (1995). Design fluency in dementia of Alzheimer's type, multi-infarct dementia and dementia associated with alcoholism. Applied Neuropsychology, 2 (1), 7 – 14. doi: 10.1207/s15324826an0201_2</bibtext> </blist> <blist> <bibtext> Bigler, E. D., Schultz, R., Grant, M., Knight, G., Lucas, J. ... Sullivan, M. (1988). Design fluency in dementia of the Alzheimer's type: Preliminary findings. Neuropsychology, 2 (3–4), 127. doi: 10.1037/h0091736</bibtext> </blist> <blist> <bibtext> Borne, L., Tian, Y., Lupton, M., van der Meer, J., Jeganathan, J. ... Breakspear, M. (2023). Functional re- organization of hippocampal-cortical gradients during naturalistic memory processes. Neuroimage: Reports, 271, 119996. doi: 10.1016/j.neuroimage.2023.119996</bibtext> </blist> <blist> <bibtext> Bourgeat, P., Dore, V., Fripp, J., Ames, D., Masters, C. ... Rowe, C. (2018). Implementing the centiloid transformation for 11C-PiB and β - amyloid 18F-PET tracers using CapAIBL. Neuroimage: Reports, 183, 387 – 393. doi: 10.1016/j.neuroimage.2018.08.044</bibtext> </blist> <blist> <bibtext> Bright, P., Hale, E., Gooch, V. J., Myhill, T., & van der Linde, I. (2018). The national adult reading test: Restandardisation against the Wechsler adult intelligence scale-fourth edition. Neuropsychological Rehabilitation, 28 (6), 1019 – 1027. doi: 10.1080/09602011.2016.1231121</bibtext> </blist> <blist> <bibtext> Bright, P., Jaldow, E., & Kopelman, M. D. (2002). The national adult reading test as a measure of premorbid intelligence: A comparison with estimates derived from demographic variables. Journal of the International Neuropsychological Society, 8 (6), 847 – 854. doi: 10.1017/S1355617702860131</bibtext> </blist> <blist> <bibtext> Burgess, P. W., & Shallice, T. (1997). The Hayling and Brixton tests. Bury St, Edmunds : Thames Valley Test Company.</bibtext> </blist> <blist> <bibtext> Carson, S. H. (2009). Creativity and the Aging Brain: Using the Powers of the Ageing Brain to Enhance Creativity. https://<ulink href="http://www.psychologytoday.com/blog/life-art/200903/creativity-and-the-agingbrain">www.psychologytoday.com/blog/life-art/200903/creativity-and-the-agingbrain</ulink></bibtext> </blist> <blist> <bibtext> Christensen, A. P., Kenett, Y. N., Cotter, K. N., Beaty, R. E., & Silvia, P. J. (2018). Remotely close associations: Openness to experience and semantic memory structure. European Journal of Personality, 32 (4), 480 – 492. doi: 10.1002/per.2157</bibtext> </blist> <blist> <bibtext> de Souza, L. C., Volle, E., Bertoux, M., Czernecki, V., Funkiewiez, A. ... Levy, R. (2010). Poor creativity in frontotemporal dementia: A window into the neural bases of the creative mind. Neuropsychologia, 48 (13), 3733 – 3742. doi: 10.1016/j.neuropsychologia.2010.09.010</bibtext> </blist> <blist> <bibtext> DeYoung, C. G., Flanders, J. L., & Peterson, J. B. (2008). Cognitive abilities involved in insight problem solving: An individual differences model. Creativity Research Journal, 20 (3), 278 – 290. doi: 10.1080/10400410802278719</bibtext> </blist> <blist> <bibtext> Farias, S. T., Mungas, D., Reed, B. R., Harvey, D., & DeCarli, C. (2009). Progression of mild cognitive impairment to dementia in clinic- vs community-based cohorts. Archives of Neurology, 66 (9), 1151 – 1157. doi: 10.1001/archneurol.2009.106</bibtext> </blist> <blist> <bibtext> Feist, G. J. (1998). A meta-analysis of personality in scientific and artistic creativity. Personality and Social Psychology Review, 2 (4), 290 – 309. doi: 10.1207/s15327957pspr0204_5</bibtext> </blist> <blist> <bibtext> Finke, R. A., Ward, T. B., & Smith, S. M. (1992). Creative cognition: Theory, research, and applications. Cambridge, MA : MIT Press.</bibtext> </blist> <blist> <bibtext> Fink, A., Grabner, R. H., Benedek, M., Reishofer, G., Hauswirth, V. ... Neubauer, A. C. (2009). The creative brain: Investigation of brain activity during creative problem solving by means of EEG and FMRI. Human Brain Mapping, 30 (3), 734 – 748. doi: 10.1002/hbm.20538</bibtext> </blist> <blist> <bibtext> Flaherty, A. W. (2005). Frontotemporal and dopaminergic control of idea generation and creative drive. Journal of Comparative Neurology, 493 (1), 147 – 153. doi: 10.1002/cne.20768</bibtext> </blist> <blist> <bibtext> Fodero-Tavoletti, M., Brockschnieder, D., Villemagne, V., Martin, L., Connor, A. ... Cappai, R. (2012). In vitro characterization of [18F]-florbetaben, an A β imaging radiotracer. Nuclear Medicine and Biology, 39 (7), 1042 – 1048. doi: 10.1016/j.nucmedbio.2012.03.001</bibtext> </blist> <blist> <bibtext> Foldi, N. S., Helm-Estabrooks, N., Redfield, J., & Nickel, D. G. (2003). Perseveration in normal aging: A comparison of perseveration rates on design fluency and verbal generative tasks. Aging, Neuropsychology & Cognition, 10 (4), 268 – 280. doi: 10.1076/anec.10.4.268.28970</bibtext> </blist> <blist> <bibtext> Frisoni, G. B., Prestia, A., Rasser, P. E., Bonetti, M., & Thompson, P. M. (2009). In vivo mapping of incremental cortical atrophy from incipient to overt Alzheimer's disease. Journal of Neurology, 256 (6), 916 – 924. doi: 10.1007/s00415-009-5040-7</bibtext> </blist> <blist> <bibtext> Fuster, J. M. (2015). The prefrontal cortex (5 th ed.). London : Academic Press.</bibtext> </blist> <blist> <bibtext> Gerver, C. R., Griffin, J. W., Dennis, N. A., & Beaty, R. E. (2023). Memory and creativity: A meta-analytic examination of the relationship between memory systems and creative cognition. Psychonomic Bulletin & Review, 30 (6), 2116 – 2154. doi: 10.3758/s13423-023-02303-4</bibtext> </blist> <blist> <bibtext> Gibson, E. C., Barker, M. S., Martin, A. K., & Robinson, G. A. (2019). Initiation, inhibition and strategy generation across the healthy adult lifespan. Archives of Clinical Neuropsychology, 34 (4), 511 – 523. doi: 10.1093/arclin/acy057</bibtext> </blist> <blist> <bibtext> Gilhooly, K., Fioratou, E., Anthony, S., & Wynn, V. (2007). Divergent thinking: Strategies for generating alternative uses for familiar objects. British Journal of Psychology, 98 (4), 611 – 625. doi: 10.1111/j.2044-8295.2007.tb00467.x</bibtext> </blist> <blist> <bibtext> Guilford, J. P. (1967). The nature of human intelligence. New York : McGraw-Hill.</bibtext> </blist> <blist> <bibtext> Hart, R. P., & Wade, J. B. (2006). Divergent Thinking in Alzheimer's and Frontotemporal Dementia. Aging, Neuropsychology & Cognition, 13 (3–4), 281 – 290. doi: 10.1080/13825580490904246</bibtext> </blist> <blist> <bibtext> Hull, M. (2018). Generation of novel responses: An investigation of healthy ageing and bipolar disorder [ Doctor of Psychology Thesis ]. The University of Queensland, School of Psychology.</bibtext> </blist> <blist> <bibtext> Jones-Gotman, M., & Milner, B. (1977). Design fluency: The invention of nonsense drawings after focal cortical lesions. Neuropsychologia, 15 (4–5), 653 – 674. doi: 10.1016/0028-3932(77)90070-7</bibtext> </blist> <blist> <bibtext> Jung-Beeman, M., Bowden, E. M., Haberman, J., Frymiare, J. L., Arambel-Liu, S. ... Dehaene, S. (2004). Neural activity when people solve verbal problems with insight. PLOS Biology, 2 (4), e97. doi: 10.1371/journal.pbio.0020097</bibtext> </blist> <blist> <bibtext> Katzman, R., Terry, R., DeTeresa, R., Brown, T., Davies, P. ... Peck, A. (1988). Clinical, pathological, and neurochemical changes in dementia: A subgroup with preserved mental status and numerous neocortical plaques. Annals of Neurology, 23 (2), 138 – 144. doi: 10.1002/ana.410230206</bibtext> </blist> <blist> <bibtext> Kim, S., Hasher, L., & Zacks, R. T. (2007). Aging and a benefit of distractibility. Psychonomic Bulletin & Review, 14 (2), 301 – 305. doi: 10.3758/BF03194068</bibtext> </blist> <blist> <bibtext> Kleinmintz, O. M., Ivancovsky, T., & Shamay-Tsoory, S. G. (2019). The two-fold model of creativity: The neural underpinnings of the generation and evaluation of creative ideas. Current Opinion in Behavioral Sciences, 27, 131 – 138. doi: 10.1016/j.cobeha.2018.11.004</bibtext> </blist> <blist> <bibtext> Klooster, N., & Duff, M. (2015). Remote semantic memory is impoverished in hippocampal amnesia—ScienceDirect. Neuropsychologia, 79, 42 – 52. doi: 10.1016/j.neuropsychologia.2015.10.017</bibtext> </blist> <blist> <bibtext> Klooster, N., Humphries, S., Cardillo, E., Hartung, F., Xie, L. ... Loewenstein, D. (2021). Sensitive measures of cognition in mild cognitive impairment—PMC. Journal of Alzheimer's Disease, 82 (3), 1123 – 1136. doi: 10.3233/JAD-201280</bibtext> </blist> <blist> <bibtext> Kounios, J., Fleck, J. I., Green, D. L., Payne, L., Stevenson, J. L., Bowden, E. M., & Jung-Beeman, M. (2008). The origins of insight in resting-state brain activity. Neuropsychologia, 46 (1), 281 – 291. doi: 10.1016/j.neuropsychologia.2007.07.013</bibtext> </blist> <blist> <bibtext> Kumar, R., Koirala, P., & Tiwari, S. (2015). Higher mental functioning in dementia: A status assessment. Journal of Geriatric Mental Health, 2 (1), 42. doi: 10.4103/2348-9995.161382</bibtext> </blist> <blist> <bibtext> Lambon Ralph, M. A. L., Jefferies, E., Patterson, K., & Rogers, T. T. (2017). The neural and computational bases of semantic cognition. Nature Reviews Neuroscience, 18 (1), 42 – 55. Article 1. doi: 10.1038/nrn.2016.150</bibtext> </blist> <blist> <bibtext> Lee, C. S., Huggins, A. C., & Therriault, D. J. (2014). A measure of creativity or intelligence? Examining internal and external structure validity evidence of the remote associates test. Psychology of Aesthetics, Creativity, and the Arts, 8 (4), 446 – 460. doi: 10.1037/a0036773</bibtext> </blist> <blist> <bibtext> Lezak, M. D., Howieson, D. B., Loring, D. W., Hannay, H. J., & Fischer, J. S. (2004). Neuropsychological assessment (4th ed., pp. xiv, 1016). New York : Oxford University Press.</bibtext> </blist> <blist> <bibtext> Li, W., Li, G., Ji, B., Zhang, Q., & Qiu, J. (2019). Neuroanatomical correlates of creativity: Evidence from Voxel-Based Morphometry. Frontiers in Psychology, 10, 10. doi: 10.3389/fpsyg.2019.00155</bibtext> </blist> <blist> <bibtext> Lonie, J. A., Herrmann, L. L., Tierney, K. M., Donaghey, C., O'Carroll, R., Lee, A., & Ebmeier, K. P. (2009). Lexical and semantic fluency discrepancy scores in aMCI and early Alzheimer's disease. Journal of Neuropsychology, 3 (1), 79 – 92. doi: 10.1348/174866408X289935</bibtext> </blist> <blist> <bibtext> Lupton, M. K., Robinson, G. A., Adam, R. J., Rose, S., Byrne, G. J., Salvado, O., & Breakspear, M. (2021). A prospective cohort study of prodromal Alzheimer's disease: Prospective imaging study of ageing: Genes, brain and behaviour (PISA). NeuroImage Clinical, 29, 102527. https://doi.org/10.1016/j.nicl.2020.102527</bibtext> </blist> <blist> <bibtext> Marko, M., Michalko, D., & Riečanský, I. (2019). Remote associates test: An empirical proof of concept. Behavior Research Methods, 51 (6), 2700 – 2711. doi: 10.3758/s13428-018-1131-7</bibtext> </blist> <blist> <bibtext> Martin, A. K., Barker, M. S., Gibson, E. C., & Robinson, G. A. (2021). Response initiation and inhibition and the relationship with fluid intelligence across the adult lifespan. Archives of Clinical Neuropsychology, 36 (2), 231 – 242. doi: 10.1093/arclin/acz044</bibtext> </blist> <blist> <bibtext> McDonald, C. R., Gharapetian, L., McEvoy, L. K., Fennema-Notestine, C., Hagler, D. J., Holland, D., & Dale, A. M. (2012). Relationship between regional atrophy rates and cognitive decline in mild cognitive impairment. Neurobiology of Aging, 33 (2), 242 – 253. doi: 10.1016/j.neurobiolaging.2010.03.015</bibtext> </blist> <blist> <bibtext> McHugh, M. L. (2012). Interrater reliability: The kappa statistic. Biochemical medicine, 276 – 282. https://doi.org/10.11613/BM.2012.031</bibtext> </blist> <blist> <bibtext> McKenna, P., & Warrington, E. K. (1980). Testing for nominal dysphasia. Journal of Neurology, Neurosurgery, and Psychiatry, 43 (9), 781 – 788. doi: 10.1136/jnnp.43.9.781</bibtext> </blist> <blist> <bibtext> McKhann, G. M., Knopman, D. S., Chertkow, H, H., Hyman, B. T., Jack Jr, C. R., Kawas, C. H., & Phelps, C. H. (2011). The diagnosis of dementia due to Alzheimer's disease: Recommendations from the National Institute on Aging‐Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & Dementia, 7 (3), 263 – 269. https://doi.org/10.1016/j.jalz.2011.03.005</bibtext> </blist> <blist> <bibtext> Mednick, S. (1962). The associative basis of the creative process. Psychological Review, 69 (3), 220 – 232. doi: 10.1037/h0048850</bibtext> </blist> <blist> <bibtext> Murman, D. (2015). The impact of age on cognition. Seminars in Hearing, 36 (3), 111 – 121. doi: 10.1055/s-0035-1555115</bibtext> </blist> <blist> <bibtext> Nelson, H. E., & Willison, J. R. (1991). The revised national adult reading test—test manual. NFER – Nelson.</bibtext> </blist> <blist> <bibtext> Palmiero, M., Di Giacomo, D., & Passafiume, D. (2012). Creativity and dementia: A review. Cognitive Processing, 13 (3), 193 – 209. doi: 10.1007/s10339-012-0439-y</bibtext> </blist> <blist> <bibtext> Perry, R. J., Watson, P., & Hodges, J. R. (2000). The nature and staging of attention dysfunction in early (minimal and mild) Alzheimer's disease: Relationship to episodic and semantic memory impairment. Neuropsychologia, 38 (3), 252 – 271. doi: 10.1016/S0028-3932(99)00079-2</bibtext> </blist> <blist> <bibtext> Petersen, R. C., Doody, R., Kurz, A., Mohs, R. C., Morris, J. C. ... Winblad, B. (2001). Current concepts in mild cognitive impairment. Archives of Neurology, 58 (12), 1985 – 1992. doi: 10.1001/archneur.58.12.1985</bibtext> </blist> <blist> <bibtext> Pini, L., Pievani, M., Bocchetta, M., Altomare, D., Bosco, P. ... Frisoni, G. B. (2016). Brain atrophy in Alzheimer's disease and aging. Ageing Research Reviews, 30, 25 – 48. doi: 10.1016/j.arr.2016.01.002</bibtext> </blist> <blist> <bibtext> Rapp, M. A., & Reischies, F. M. (2005). Attention and executive control predict Alzheimer disease in late life: Results from the Berlin Aging Study (BASE). The American Journal of Geriatric Psychiatry, 13 (2), 134 – 141. doi: 10.1097/00019442-200502000-00007</bibtext> </blist> <blist> <bibtext> Rees, H. J., & Israel, H. E. (1935). An investigation of the establishment and operation of mental sets. Psychological Monographs, 46 (6), 1 – 26. doi: 10.1037/h0093375</bibtext> </blist> <blist> <bibtext> Robinson, G. A., Cipolotti, L., Walker, D. G., Biggs, V., Bozzali, M., & Shallice, T. (2015). Verbal suppression and strategy use: A role for the right lateral prefrontal cortex? Brain A Journal of Neurology, 138 (4), 1084 – 1096. doi: 10.1093/brain/awv003</bibtext> </blist> <blist> <bibtext> Robinson, G., Shallice, T., Bozzali, M., & Cipolotti, L. (2012). The differing roles of the frontal cortex in fluency tests. Brain A Journal of Neurology, 135 (7), 2202 – 2214. doi: 10.1093/brain/aws142</bibtext> </blist> <blist> <bibtext> Robinson, G. A., Tjokrowijoto, P., Ceslis, A., Biggs, V., Bozzali, M., & Walker, D. G. (2021). Fluency test generation and errors in focal frontal and posterior lesions. Neuropsychologia, 163, 108085. doi: 10.1016/j.neuropsychologia.2021.108085</bibtext> </blist> <blist> <bibtext> Rowe, C., Ackerman, U., Browne, W., Mulligan, R., Pike, K. ... Villemagne, V. (2008). Imaging of amyloid β in Alzheimer's disease with 18F-BAY94-9172, a novel PET tracer: Proof of mechanism. The Lancet Neurology, 7 (2), 129 – 135. doi: 10.1016/S1474-4422(08)70001-2</bibtext> </blist> <blist> <bibtext> Runco, M. (2014). Creativity: Theories and themes: Research, development, and practice (2nd ed.). San Diego, CA : Academic Press.</bibtext> </blist> <blist> <bibtext> Salthouse, T. A. (2009). When does age-related cognitive decline begin? Neurobiology of Aging, 30 (4), 507 – 514. doi: 10.1016/j.neurobiolaging.2008.09.023</bibtext> </blist> <blist> <bibtext> Stein, M. I. (1953). Creativity and culture. The Journal of Psychology, 36 (2), 311 – 322. doi: 10.1080/00223980.1953.9712897</bibtext> </blist> <blist> <bibtext> Sternberg, R. J. (1999). Handbook of creativity. New York : Cambridge University Press.</bibtext> </blist> <blist> <bibtext> Stuss, D. T., & Alexander, M. P. (2007). Is there a dysexecutive syndrome? Philosophical Transactions of the Royal Society B: Biological Sciences, 362 (1481), 901 – 915. doi: 10.1098/rstb.2007.2096</bibtext> </blist> <blist> <bibtext> Traykov, L., Raoux, N., Latour, F., Gallo, L., Hanon, O. ... Rigaud, A.-S. (2007). Executive functions deficit in mild cognitive impairment. Cognitive and Behavioral Neurology, 20 (4), 219 – 224. doi: 10.1097/WNN.0b013e31815e6254</bibtext> </blist> <blist> <bibtext> Turner, M. A. (1999). Generating novel ideas: Fluency performance in high-functioning and learning disabled individuals with autism. Journal of Child Psychology and Psychiatry, 40 (2), 189 – 201. doi: 10.1111/1469-7610.00432</bibtext> </blist> <blist> <bibtext> Turner, M. S., Cipolotti, L., Yousry, T., & Shallice, T. (2007). Qualitatively different memory impairments across frontal lobe subgroups. Neuropsychologia, 45 (7), 1540 – 1552. doi: 10.1016/j.neuropsychologia.2006.11.013</bibtext> </blist> <blist> <bibtext> Verma, M., & Howard, R. J. (2012). Semantic memory and language dysfunction in early Alzheimer's disease: A review. International Journal of Geriatric Psychiatry, 27 (12), 1209 – 1217. doi: 10.1002/gps.3766</bibtext> </blist> <blist> <bibtext> Volle, E. (2017). Associative and controlled cognition in divergent thinking: Theoretical, experimental, neuroimaging evidence, and new directions. The Cambridge Handbook of the Neuroscience of Creativity. doi: 10.1017/9781316556238.020</bibtext> </blist> <blist> <bibtext> Warrington, E. K. (1984). Recognition memory test. Los Angeles : Western Psychological Services.</bibtext> </blist> <blist> <bibtext> Warrington, E. K. (1997). The graded naming test: A restandardisation. Neuropsychological Rehabilitation, 7 (2), 143 – 146. doi: 10.1080/713755528</bibtext> </blist> <blist> <bibtext> Webb, M. E., Little, D. R., Cropper, S. J., & Roze, K. (2017). The contributions of convergent thinking, divergent thinking, and schizotypy to solving insight and non-insight problems. Thinking & Reasoning, 23 (3), 235 – 258. doi: 10.1080/13546783.2017.1295105</bibtext> </blist> <blist> <bibtext> Yi, H.-A., Möller, C., Dieleman, N., Bouwman, F. H., Barkhof, F. ... Vrenken, H. (2016). Relation between subcortical grey matter atrophy and conversion from mild cognitive impairment to Alzheimer's disease. Journal of Neurology, Neurosurgery & Psychiatry, 87 (4), 425 – 432. doi: 10.1136/jnnp-2014-309105</bibtext> </blist> <blist> <bibtext> Zhang, W., Sjoerds, Z., & Hommel, B. (2020). Metacontrol of human creativity: The neurocognitive mechanisms of convergent and divergent thinking. Neuroimage: Reports, 210, 116572. doi: 10.1016/j.neuroimage.2020.116572</bibtext> </blist> </ref> <aug> <p>By Georgia Marsh; Ohnmar Aung; Amelia Ceslis; Robert Adam; Philip Mosley; Jurgen Fripp and Gail A. Robinson</p> <p>Reported by Author; Author; Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib23" firstref="ref2"></nolink> <nolink nlid="nl2" bibid="bib73" firstref="ref3"></nolink> <nolink nlid="nl3" bibid="bib74" firstref="ref4"></nolink> <nolink nlid="nl4" bibid="bib71" firstref="ref7"></nolink> <nolink nlid="nl5" bibid="bib26" firstref="ref8"></nolink> <nolink nlid="nl6" bibid="bib36" firstref="ref9"></nolink> <nolink nlid="nl7" bibid="bib24" firstref="ref15"></nolink> <nolink nlid="nl8" bibid="bib58" firstref="ref16"></nolink> <nolink nlid="nl9" bibid="bib34" firstref="ref17"></nolink> <nolink nlid="nl10" bibid="bib48" firstref="ref18"></nolink> <nolink nlid="nl11" bibid="bib68" firstref="ref19"></nolink> <nolink nlid="nl12" bibid="bib78" firstref="ref21"></nolink> <nolink nlid="nl13" bibid="bib41" firstref="ref22"></nolink> <nolink nlid="nl14" bibid="bib33" firstref="ref34"></nolink> <nolink nlid="nl15" bibid="bib80" firstref="ref38"></nolink> <nolink nlid="nl16" bibid="bib85" firstref="ref39"></nolink> <nolink nlid="nl17" bibid="bib38" firstref="ref40"></nolink> <nolink nlid="nl18" bibid="bib44" firstref="ref41"></nolink> <nolink nlid="nl19" bibid="bib49" firstref="ref42"></nolink> <nolink nlid="nl20" bibid="bib40" firstref="ref46"></nolink> <nolink nlid="nl21" bibid="bib18" firstref="ref49"></nolink> <nolink nlid="nl22" bibid="bib32" firstref="ref50"></nolink> <nolink nlid="nl23" bibid="bib53" firstref="ref51"></nolink> <nolink nlid="nl24" bibid="bib59" firstref="ref52"></nolink> <nolink nlid="nl25" bibid="bib72" firstref="ref53"></nolink> <nolink nlid="nl26" bibid="bib10" firstref="ref54"></nolink> <nolink nlid="nl27" bibid="bib13" firstref="ref55"></nolink> <nolink nlid="nl28" bibid="bib61" firstref="ref56"></nolink> <nolink nlid="nl29" bibid="bib30" firstref="ref57"></nolink> <nolink nlid="nl30" bibid="bib67" firstref="ref58"></nolink> <nolink nlid="nl31" bibid="bib54" firstref="ref60"></nolink> <nolink nlid="nl32" bibid="bib46" firstref="ref62"></nolink> <nolink nlid="nl33" bibid="bib31" firstref="ref63"></nolink> <nolink nlid="nl34" bibid="bib64" firstref="ref64"></nolink> <nolink nlid="nl35" bibid="bib11" firstref="ref65"></nolink> <nolink nlid="nl36" bibid="bib12" firstref="ref66"></nolink> <nolink nlid="nl37" bibid="bib20" firstref="ref67"></nolink> <nolink nlid="nl38" bibid="bib35" firstref="ref68"></nolink> <nolink nlid="nl39" bibid="bib39" firstref="ref69"></nolink> <nolink nlid="nl40" bibid="bib45" firstref="ref70"></nolink> <nolink nlid="nl41" bibid="bib79" firstref="ref72"></nolink> <nolink nlid="nl42" bibid="bib29" firstref="ref77"></nolink> <nolink nlid="nl43" bibid="bib84" firstref="ref80"></nolink> <nolink nlid="nl44" bibid="bib76" firstref="ref82"></nolink> <nolink nlid="nl45" bibid="bib22" firstref="ref83"></nolink> <nolink nlid="nl46" bibid="bib62" firstref="ref84"></nolink> <nolink nlid="nl47" bibid="bib63" firstref="ref85"></nolink> <nolink nlid="nl48" bibid="bib65" firstref="ref86"></nolink> <nolink nlid="nl49" bibid="bib42" firstref="ref87"></nolink> <nolink nlid="nl50" bibid="bib43" firstref="ref88"></nolink> <nolink nlid="nl51" bibid="bib50" firstref="ref90"></nolink> <nolink nlid="nl52" bibid="bib51" firstref="ref105"></nolink> <nolink nlid="nl53" bibid="bib57" firstref="ref106"></nolink> <nolink nlid="nl54" bibid="bib60" firstref="ref111"></nolink> <nolink nlid="nl55" bibid="bib15" firstref="ref112"></nolink> <nolink nlid="nl56" bibid="bib16" firstref="ref113"></nolink> <nolink nlid="nl57" bibid="bib56" firstref="ref114"></nolink> <nolink nlid="nl58" bibid="bib82" firstref="ref115"></nolink> <nolink nlid="nl59" bibid="bib25" firstref="ref116"></nolink> <nolink nlid="nl60" bibid="bib81" firstref="ref117"></nolink> <nolink nlid="nl61" bibid="bib17" firstref="ref118"></nolink> <nolink nlid="nl62" bibid="bib27" firstref="ref122"></nolink> <nolink nlid="nl63" bibid="bib70" firstref="ref123"></nolink> <nolink nlid="nl64" bibid="bib14" firstref="ref124"></nolink> <nolink nlid="nl65" bibid="bib37" firstref="ref134"></nolink> <nolink nlid="nl66" bibid="bib69" firstref="ref137"></nolink> <nolink nlid="nl67" bibid="bib66" firstref="ref140"></nolink> <nolink nlid="nl68" bibid="bib52" firstref="ref153"></nolink> <nolink nlid="nl69" bibid="bib104" firstref="ref167"></nolink> <nolink nlid="nl70" bibid="bib55" firstref="ref184"></nolink> <nolink nlid="nl71" bibid="bib47" firstref="ref192"></nolink> <nolink nlid="nl72" bibid="bib28" firstref="ref197"></nolink> <nolink nlid="nl73" bibid="bib21" firstref="ref198"></nolink> <nolink nlid="nl74" bibid="bib77" firstref="ref203"></nolink> <nolink nlid="nl75" bibid="bib83" firstref="ref204"></nolink> <nolink nlid="nl76" bibid="bib19" firstref="ref205"></nolink> <nolink nlid="nl77" bibid="bib75" firstref="ref208"></nolink>
Header DbId: eric
DbLabel: ERIC
An: EJ1493563
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Generation of Novel Ideas: Creativity in Alzheimer's Disease, Mild Cognitive Impairment, and Healthy Older Adults
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Georgia+Marsh%22">Georgia Marsh</searchLink><br /><searchLink fieldCode="AR" term="%22Ohnmar+Aung%22">Ohnmar Aung</searchLink><br /><searchLink fieldCode="AR" term="%22Amelia+Ceslis%22">Amelia Ceslis</searchLink><br /><searchLink fieldCode="AR" term="%22Robert+Adam%22">Robert Adam</searchLink><br /><searchLink fieldCode="AR" term="%22Philip+Mosley%22">Philip Mosley</searchLink><br /><searchLink fieldCode="AR" term="%22Jurgen+Fripp%22">Jurgen Fripp</searchLink><br /><searchLink fieldCode="AR" term="%22Gail+A%2E+Robinson%22">Gail A. Robinson</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Creativity+Research+Journal%22"><i>Creativity Research Journal</i></searchLink>. 2025 37(3):342-357.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 16
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2025
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Creativity%22">Creativity</searchLink><br /><searchLink fieldCode="DE" term="%22Alzheimers+Disease%22">Alzheimers Disease</searchLink><br /><searchLink fieldCode="DE" term="%22Neurological+Impairments%22">Neurological Impairments</searchLink><br /><searchLink fieldCode="DE" term="%22Older+Adults%22">Older Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Severity+%28of+Disability%29%22">Severity (of Disability)</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+Ability%22">Cognitive Ability</searchLink><br /><searchLink fieldCode="DE" term="%22Aging+%28Individuals%29%22">Aging (Individuals)</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Australia%22">Australia</searchLink>
– Name: SubjectThesaurus
  Label: Assessment and Survey Identifiers
  Group: Su
  Data: <searchLink fieldCode="SU" term="%22Sentence+Completion+Test%22">Sentence Completion Test</searchLink><br /><searchLink fieldCode="SU" term="%22Remote+Associates+Test%22">Remote Associates Test</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/10400419.2024.2304498
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1040-0419<br />1532-6934
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Creativity refers to the ability to produce ideas or actions that are novel and useful, incorporating convergent and divergent thinking. Currently, limited attention has been paid to changes in creativity with disease progression (e.g. mild cognitive impairment and Alzheimer's disease). Therefore, this study examined the patterns of creativity between healthy controls (n = 36), adults with mild cognitive impairment (MCI; n = 23), and adults with Alzheimer's disease (AD; n = 21). The study explored whether performance on creativity tasks can predict clinical group and contributing cognitive processes. Various cognitive tests were administered to participants, including measures of creativity. Our findings suggested that creative thought is reduced in individuals with MCI and AD, such that the AD group generated the lowest number of correct responses and made the most errors on all creativity tasks, indicating that creative ability decreases as dementia progresses. Performance on creativity tasks could also predict clinical group (depending on the task, ranging from 49% to 82% of those having MCI), indicating sensitivity to novel idea generation, which has been linked to frontal lobe impairment. Our findings suggested that core cognitive processes underlying creativity, including semantic knowledge and executive functions, are critical for producing new creative thoughts.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2026
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1493563
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1493563
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/10400419.2024.2304498
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 16
        StartPage: 342
    Subjects:
      – SubjectFull: Creativity
        Type: general
      – SubjectFull: Alzheimers Disease
        Type: general
      – SubjectFull: Neurological Impairments
        Type: general
      – SubjectFull: Older Adults
        Type: general
      – SubjectFull: Severity (of Disability)
        Type: general
      – SubjectFull: Cognitive Ability
        Type: general
      – SubjectFull: Aging (Individuals)
        Type: general
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: College Students
        Type: general
      – SubjectFull: Australia
        Type: general
      – SubjectFull: Sentence Completion Test
        Type: general
      – SubjectFull: Remote Associates Test
        Type: general
    Titles:
      – TitleFull: Generation of Novel Ideas: Creativity in Alzheimer's Disease, Mild Cognitive Impairment, and Healthy Older Adults
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Georgia Marsh
      – PersonEntity:
          Name:
            NameFull: Ohnmar Aung
      – PersonEntity:
          Name:
            NameFull: Amelia Ceslis
      – PersonEntity:
          Name:
            NameFull: Robert Adam
      – PersonEntity:
          Name:
            NameFull: Philip Mosley
      – PersonEntity:
          Name:
            NameFull: Jurgen Fripp
      – PersonEntity:
          Name:
            NameFull: Gail A. Robinson
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2025
          Identifiers:
            – Type: issn-print
              Value: 1040-0419
            – Type: issn-electronic
              Value: 1532-6934
          Numbering:
            – Type: volume
              Value: 37
            – Type: issue
              Value: 3
          Titles:
            – TitleFull: Creativity Research Journal
              Type: main
ResultId 1