The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale. Two methods to assess fluctuating confusion in dementia.
BACKGROUND
The identification of fluctuating confusion is central to improving the differential diagnosis of the common dementias.


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


METHODS
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.
Walker
M P
MP
Medical Research Council, Neurochemical Pathology Unit, Newcastle upon Tyne, UK.
Ayre
G A
GA
Cummings
J L
JL
Wesnes
K
K
McKeith
I G
IG
O'Brien
J T
JT
Ballard
C G
CG
D000368:Aged; D002985:Clinical Protocols; D003221:Confusion / Q000175:diagnosis*; D003704:Dementia / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000379:methods; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012107:Research Design