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

American Journal of Alzheimer's Disease and Other Dementias
Kathleen Van DykYaakov Stern

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.

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Citations

Aug 15, 2019·Brain : a Journal of Neurology·Seán O'DowdJohn-Paul Taylor
Oct 23, 2019·JAMA : the Journal of the American Medical Association·Zoe ArvanitakisDavid A Bennett
Nov 2, 2019·Journal of Geriatric Psychiatry and Neurology·Joseph R PhillipsSimon J G Lewis
Nov 19, 2020·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·N G Dudchenko, E E Vasenina
Jan 7, 2021·Seminars in Nuclear Medicine·John A DuignanRonan P Killeen
May 16, 2021·Alzheimer's & Dementia : the Journal of the Alzheimer's Association·Yaakov SternYian Gu
Jul 3, 2021·Behavioral Sciences·Ángela Milán-TomásMaría Cruz Rodríguez-Oroz
Aug 11, 2020·Journal of the American Medical Directors Association·Robert EspinosaDaniel Weintraub
Dec 4, 2021·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Shannon Y ChiuMelissa J Armstrong

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