Format

Send to

Choose Destination
Am J Alzheimers Dis Other Demen. 2016 Mar;31(2):137-43. doi: 10.1177/1533317515603359. Epub 2015 Sep 3.

Assessing Fluctuating Cognition in Dementia Diagnosis: Interrater Reliability of the Clinician Assessment of Fluctuation.

Author information

1
Cognitive Neuroscience Division, Department of Neurology, Columbia University Medical Center, New York, NY, USA Department of Psychology, Queens College and The Graduate Center, City University of New York, New York, NY, USA.
2
Cognitive Neuroscience Division, Department of Neurology, Columbia University Medical Center, New York, NY, USA Department of Clinical Psychology, Antioch University New England, Keene, NH, USA.
3
Cognitive Neuroscience Division, Department of Neurology, Columbia University Medical Center, New York, NY, USA.
4
Cognitive Neuroscience Division, Department of Neurology, Columbia University Medical Center, New York, NY, USA ys11@columbia.edu.

Abstract

Fluctuating cognition (FC) is a core feature of dementia with Lewy bodies (DLB) but is challenging to assess. This study assessed the reliability and validity of the Clinician Assessment of Fluctuation (CAF), which assesses FC in patients with dementia. Interrater agreement of CAF outcomes (FC present and FC severe) was evaluated between physicians and nonphysicians in 141 patients with Alzheimer's disease (AD) or DLB. Frequency of CAF outcomes by clinical and neuropathological diagnosis was examined. We found that interrater reliability was fair on FC present and almost perfect on FC severe, and both outcomes were higher in patients with clinical DLB than with clinical AD and were qualitatively more often endorsed in cases with neuropathological evidence of Lewy bodies. We conclude that the CAF is a reliable measure of FC and can be valuable in differential dementia diagnosis.

KEYWORDS:

Alzheimer’s Disease; dementia; dementia with Lewy Bodies; fluctuating cognition

PMID:
26340964
PMCID:
PMC4758876
DOI:
10.1177/1533317515603359
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center