The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale

Abstract

BackgroundThe identification of fluctuating confusion is central to improving the differential diagnosis of the common dementias.AimsTo determine the value of two rating scales to measure fluctuating confusion.MethodThe 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).ResultsThe 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.ConclusionsBoth scales are useful instruments for the clinical assessment of fluctuation in dementia.