Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/9701
Title: Fluctuating cognition in dementia with Lewy bodies and Alzheimer's disease is qualitatively distinct.
Austin Authors: Bradshaw, Jennifer;Saling, Michael M ;Hopwood, M;Anderson, V;Brodtmann, Amy 
Affiliation: Austin Health, Heidelberg, Victoria, Australia
Issue Date: 1-Mar-2004
Publication information: Journal of Neurology, Neurosurgery, and Psychiatry; 75(3): 382-7
Abstract: To document and illustrate qualitative features of fluctuating cognition as described by care givers of patients with probable dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). To determine whether the quality of the fluctuations differs between DLB and AD. To examine the clinical utility of two recently developed rating scales.Care givers of 13 patients with early probable DLB and 12 patients with early probable AD were interviewed using the Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale, both developed recently. Descriptions of fluctuating cognition were recorded verbatim, analysed, and rated.Descriptions of fluctuating cognition in DLB had a spontaneous, periodic, transient quality, which appeared to reflect an interruption in the ongoing flow of awareness or attention that impacted on functional abilities. Descriptions of fluctuations in AD frequently highlighted episodes of memory failure, or a more enduring state shift in the form of "good" and "bad" days, typically occurring in response to the cognitive demands of the immediate environment. These qualitative differences could be detected reliably by independent raters, but were not always captured in standard severity scores.Fluctuations occurring in DLB have particular characteristics that are distinguishable from fluctuations occurring in AD. Interpretation and application of the fluctuation criterion continues to limit the diagnostic sensitivity of the consensus criteria for DLB. Findings suggest that explicit documentation and a wider appreciation of these distinctions could improve the reliability with which less experienced clinicians identify this core diagnostic feature in the clinical setting.
Gov't Doc #: 14966152
URI: http://ahro.austin.org.au/austinjspui/handle/1/9701
URL: https://pubmed.ncbi.nlm.nih.gov/14966152
Type: Journal Article
Subjects: Aged
Aged, 80 and over
Alzheimer Disease.complications.diagnosis.psychology
Caregivers
Cognition Disorders.etiology.psychology
Diagnosis, Differential
Disease Progression
Female
Humans
Lewy Body Disease.complications.diagnosis.psychology
Male
Periodicity
Severity of Illness Index
Appears in Collections:Journal articles

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