Skip to main content
×
×
Home

The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale: Two methods to assess fluctuating confusion in dementia

  • M. P. Walker (a1), G. A. Ayre (a2), J. L. Cummings (a3), K. Wesnes (a2), I. G. McKeith (a4), J. T. O'Brien (a4) and C. G. Ballard (a1)...
Abstract
Background

The identification of fluctuating confusion is central to improving the differential diagnosis of the common dementias.

Aims

To determine the value of two rating scales to measure fluctuating confusion.

Method

The agreement between the clinician-rated scale and the scale completed by a non-clinician was determined. Correlations between the two scales were calculated; variability in attention was calculated on a computerised cognitive assessment and variability in delta rhythm on an electroencephalogram (EEG).

Results

The Clinician Assessment of Fluctuation and the computerised cognitive assessment were completed for 155 patients (61 Alzheimer's disease, 37 dementia with Lewy bodies, 22 vascular dementia, 35 elderly controls). A subgroup (n=40) received a further evaluation using the One Day Fluctuation Assessment Scale and an EEG. The two scales correlated significantly with each other, and with the neuropsychological and electrophysiological measures of fluctuation.

Conclusions

Both scales are useful instruments for the clinical assessment of fluctuation in dementia.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale
      Available formats
      ×
Copyright
Corresponding author
C. G. Ballard, Medical Research Council, Neurochemical Pathology Unit, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE, UK. Tel: 0191 273 5251; fax: 0191 272 5291; e-mail: c.g.ballard@ncl.ac.uk
Footnotes
Hide All

Declaration of interest

None; source of funding: Medical Research Council.

Footnotes
References
Hide All
Altman, D. G. (1995) Practical Statistics for Medical Research, pp. 417418. London: Chapman & Hall.
Ayre, G., Ballard, C., Pincock, C., et al (2000) Double dissociation between dementia with Lewy bodies and Alzheimer's disease on tests of attentional and mnemonic function: the role of the basal forebrain. Neurology, in press.
Byrne, E. J., Lennox, G., Lowe, J., et al (1989) Diffuse Lewy body disease: clinical features in 15 cases. Journal of Neurology, Neurosurgery & Psychiatry, 52, 709717.
Devanand, D. P., Miller, L., Richards, M., et al (1992) The Columbia University scale for psychopathology in Alzheimer's disease. Archives of Neurology, 49, 371376.
Dewey, M. E., Copeland, J. R. M., Lobo, A., et al (1992) Computerized diagnosis from a standardized history schedule: a preliminary communication about the organic section of the HAS-AGECAT system. International Journal of Geriatric Psychiatry, 7, 443446.
Fahn, S., Elton, R. & Unified Parkinson's Disease Rating Development Committee (1987) Unified Parkinson's Disease Rating Scale. In Recent Developments in Parkinson's Disease (eds Fahn, S., Marsden, C. D. & Calne, D.), pp. 153163. New York: Macmillan.
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.
Inouye, S. K., van Dyck, C. H., Alessi, C. A., et al (1990) Clarifying confusion: the confusion assessment method: a new method for detection of delirium. Annals of Internal Medicine, 113, 941948.
Kolbeinsson, H. & Jonsson, A. (1993) Delirium and dementia in acute medical admissions of elderly patients in Iceland. Acta Psychiatrica Scandinavica, 87, 123127.
Litvan, I., Macintyre, A., Goetz, C. G., et al (1998) Accuracy of the clinical diagnoses of Lewy body disease, Parkinson disease, and dementia with Lewy bodies: a clinicopathologic study. Archives of Neurology, 55, 969978.
McKeith, I. G., Galasko, D., Kosaka, K., et al (1996) Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology, 47, 11131124.
McKeith, I. G., Ballard, C. G., Perry, R., et al (2000) Prospective validation of consensus criteria for the clinical diagnosis of DLB. Neurology, 54, 10501058.
Mahoney, P. M., Wood, V. A. & Wade, D. T. (1965) Functional evaluation: the BARTHEL index. Maryland State Medical Journal, 14, 6165.
McKhann, G., Drachman, D., Folstein, M., et al (1984) Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task Force on Alzheimer's disease. Neurology, 34, 939944.
Mega, M. S., Masterman, D. I., Benson, D. F., et al (1996) Dementia with Lewy bodies: reliability and validity of clinical and pathologic criteria. Neurology, 47, 14031409.
Roman, G. C., Tatemichi, T. K., Erkinjuntti, T., et al (1993) Vascular dementia: diagnostic criteria for research studies: report of the NINDS-AIREN International Workshop. Neurology, 43, 250260.
Simpson, P. M., Surmon, D. J., Wesnes, K. G., et al (1991) The cognitive drug research computerized assessment system for demented patients: a validation study. International Journal of Geriatric Psychiatry, 6, 95102.
SPSS (1992) Statistical Package for the Social Sciences [program] Windows Version, Release 5.0. Chicago, IL: SPSS Inc.
Yamamoto, T. & Imai, T. (1988) A case of diffuse Lewy body and Alzheimer's disease with periodic synchronous discharge. Journal of Neuropathology & Experimental Neurology, 47, 536548.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 69 *
Loading metrics...

Abstract views

Total abstract views: 158 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 26th May 2018. This data will be updated every 24 hours.

The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale: Two methods to assess fluctuating confusion in dementia

  • M. P. Walker (a1), G. A. Ayre (a2), J. L. Cummings (a3), K. Wesnes (a2), I. G. McKeith (a4), J. T. O'Brien (a4) and C. G. Ballard (a1)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *