Year: 2026
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Cognitive fluctuations are a core feature of dementia with Lewy bodies (DLB). Research focuses largely on early stages. We investigated fluctuation frequency and correlates in advanced DLB. METHODS: The Mayo Fluctuations Scale and Clinician Assessment of Fluctuations measured fluctuations. Analyses assessed frequency, scale correlations, and experiences correlating with baseline and longitudinal fluctuations. RESULTS: Fluctuations occurred in > 70% of the cohort across visits. Fluctuation scales correlated very weakly. Baseline fluctuations correlated with female sex, symptom burden, cognitive severity, neuropsychiatric symptom burden, hallucinations, sleepiness/alertness, parkinsonism, autonomic symptom burden, and orthostatic hypotension. Additional variables correlated with single scales. Fluctuations weakly correlated with participant quality of life and caregiver experiences. Longitudinal fluctuations correlated with other DLB features, comorbidities, and medication burden. DISCUSSION: Fluctuations are common in advanced DLB and correlate with other symptoms. Fluctuation measurement requires further conceptual and psychometric work for best approaches, including for screening and longitudinal assessments and treatment trials. STUDY REGISTRATION: NCT04829656.
DOI: 10.1002/dad2.70519
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,540
OpenAlex ID: W7224102113