Fluctuations correlates in advanced dementia with Lewy bodies: A longitudinal study
Melissa J. Armstrong, Tingchang Wang, Tracy Tholanikunnel, Hannah Jury, Kaitlin Sovich, Susan M. Maixner, Abhimanyu Mahajan, Zhigang LiAbstract
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