Moreover, the traditional metric of semantic fluency (total number of items) has been shown to fail at distinguishing non-demented APOE e4 carriers (i.e., genetic risk for Alzheimer’s disease) from non-carriers, while an alternative item-level metric was able to distinguish these groups (Vonk et al., 2019a). This evidence concerns the gene APOE and early-onset autosomal dominant Alzheimer disease.