Cognitive Fluctuations and Cognitive Test Performance Among Institutionalized Persons With Dementia

Overview

Journal Am J Alzheimers Dis Other Demen

Publisher Sage Publications

Specialty Neurology

Date 2017 Jul 15

PMID 28705013

Citations 3

Authors

Brian J Mainland

Nathan Herrmann

Sasha Mallya

Alexandra J Fiocco

Gwen-Li Sin

Kenneth I Shulman

Tisha J Ornstein

Affiliations

Soon will be listed here.

Abstract

Objective: To examine the nature and frequency of cognitive fluctuations (CFs) among institutionalized persons with dementia.

Method: A clinical interview and a medical chart review were conducted, and 55 patients were assigned a specific dementia diagnosis. The Severe Impairment Battery (SIB) was administered to assess cognitive function, and the Dementia Cognitive Fluctuation Scale (DCFS) was administered to each patient's primary nurse to determine the presence and severity of CFs.

Results: A simple linear regression model was conducted with DCFS as the predictor variable and SIB total score as the dependent variable. The overall model was significant, suggesting that score on the DCFS significantly predicted SIB total score. Additionally, greater severity of CFs predicted poorer performance in the areas of orientation, language, and praxis.

Conclusions: Results suggest that CFs exert a clinically significant influence over patients' cognitive abilities and should be considered as a source of excess disability.

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References

Briel R, McKeith I, Barker W, Hewitt Y, Perry R, Ince P . EEG findings in dementia with Lewy bodies and Alzheimer's disease. J Neurol Neurosurg Psychiatry. 1999; 66(3):401-3. PMC: 1736269. DOI: 10.1136/jnnp.66.3.401. View

Wilson R, McCann J, Li Y, Aggarwal N, Gilley D, Evans D . Nursing home placement, day care use, and cognitive decline in Alzheimer's disease. Am J Psychiatry. 2007; 164(6):910-5. DOI: 10.1176/ajp.2007.164.6.910. View

Kolbeinsson H, Jonsson A . Delirium and dementia in acute medical admissions of elderly patients in Iceland. Acta Psychiatr Scand. 1993; 87(2):123-7. DOI: 10.1111/j.1600-0447.1993.tb03342.x. View

Onofri E, Mercuri M, Donato G, Ricci S . Cognitive fluctuations in connection to dysgraphia: a comparison of Alzheimer's disease with dementia Lewy bodies. Clin Interv Aging. 2015; 10:625-33. PMC: 4381903. DOI: 10.2147/CIA.S79679. View

Escandon A, Al-Hammadi N, Galvin J . Effect of cognitive fluctuation on neuropsychological performance in aging and dementia. Neurology. 2010; 74(3):210-7. PMC: 2809035. DOI: 10.1212/WNL.0b013e3181ca017d. View

Winocur G, Moscovitch M, Freedman J . An investigation of cognitive function in relation to psychosocial variables in institutionalized old people. Can J Psychol. 1987; 41(2):257-69. DOI: 10.1037/h0084156. View

Quan H, Parsons G, Ghali W . Validity of information on comorbidity derived rom ICD-9-CCM administrative data. Med Care. 2002; 40(8):675-85. DOI: 10.1097/00005650-200208000-00007. View

Ardila A, Ostrosky-Solis F, Rosselli M, Gomez C . Age-related cognitive decline during normal aging: the complex effect of education. Arch Clin Neuropsychol. 2003; 15(6):495-513. View

Lee D, McKeith I, Mosimann U, Ghosh-Nodial A, Grayson L, Wilson B . The dementia cognitive fluctuation scale, a new psychometric test for clinicians to identify cognitive fluctuations in people with dementia. Am J Geriatr Psychiatry. 2013; 22(9):926-35. DOI: 10.1016/j.jagp.2013.01.072. View

10.

Walker M, Ayre G, Perry E, Wesnes K, McKeith I, Tovee M . Quantification and characterization of fluctuating cognition in dementia with Lewy bodies and Alzheimer's disease. Dement Geriatr Cogn Disord. 2000; 11(6):327-35. DOI: 10.1159/000017262. View

11.

Varanese S, Perfetti B, Monaco D, Thomas A, Bonanni L, Tiraboschi P . Fluctuating cognition and different cognitive and behavioural profiles in Parkinson's disease with dementia: comparison of dementia with Lewy bodies and Alzheimer's disease. J Neurol. 2010; 257(6):1004-11. DOI: 10.1007/s00415-010-5453-3. View

12.

Ganguli M, Ratcliff G, Huff F, Belle S, Kancel M, Fischer L . Effects of age, gender, and education on cognitive tests in a rural elderly community sample: norms from the Monongahela Valley Independent Elders Survey. Neuroepidemiology. 1991; 10(1):42-52. DOI: 10.1159/000110246. View

13.

Wagner M, Bachman D . Neuropsychological features of diffuse Lewy body disease. Arch Clin Neuropsychol. 1996; 11(3):175-84. View

14.

Lee J, Oh E, Jeong S, Sohn E, Lee T, Lee A . Longitudinal changes in clock drawing test (CDT) performance according to dementia subtypes and severity. Arch Gerontol Geriatr. 2010; 53(2):e179-82. DOI: 10.1016/j.archger.2010.08.010. View

15.

Ballard C, OBrien J, Gray A, Cormack F, Ayre G, Rowan E . Attention and fluctuating attention in patients with dementia with Lewy bodies and Alzheimer disease. Arch Neurol. 2001; 58(6):977-82. DOI: 10.1001/archneur.58.6.977. View

16.

Panisset M, Roudier M, Saxton J, Boller F . Severe impairment battery. A neuropsychological test for severely demented patients. Arch Neurol. 1994; 51(1):41-5. DOI: 10.1001/archneur.1994.00540130067012. View

17.

Charlson M, Pompei P, Ales K, MacKenzie C . A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40(5):373-83. DOI: 10.1016/0021-9681(87)90171-8. View

18.

Hely M, Reid W, Halliday G, McRitchie D, Leicester J, Joffe R . Diffuse Lewy body disease: clinical features in nine cases without coexistent Alzheimer's disease. J Neurol Neurosurg Psychiatry. 1996; 60(5):531-8. PMC: 486366. DOI: 10.1136/jnnp.60.5.531. View

19.

Robertsson B, Blennow K, Gottfries C, Wallin A . Delirium in dementia. Int J Geriatr Psychiatry. 1998; 13(1):49-56. DOI: 10.1002/(sici)1099-1166(199801)13:1<49::aid-gps733>3.0.co;2-4. View

20.

Deary I, Corley J, Gow A, Harris S, Houlihan L, Marioni R . Age-associated cognitive decline. Br Med Bull. 2009; 92:135-52. DOI: 10.1093/bmb/ldp033. View