ArticleMovement disorders : official journal of the Movement Disorder Society2014
Fluctuations in cognition and alertness vary independently in dementia with Lewy bodies.
Article in Movement disorders : official journal of the Movement Disorder Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Sleep disturbances in Lewy body dementia: A systematic review.International journal of geriatric psychiatry · 2022Pooled it
- Characterization of EEG Data Revealing Relationships With Cognitive and Motor Symptoms in Parkinson's Disease: A Systematic Review.Frontiers in aging neuroscience · 2020Pooled it
- Cognitive Fluctuations, Neuropsychiatric Burden, and Quality of Life in Moderate-Advanced Dementia With Lewy Bodies: The Role of Dysautonomia.Neurology · 2026Observational
- Expert Guidance on Cognitive Impairment in Alzheimer's Disease: A Practical Seven-Step Approach from the United Arab Emirates.Neurology and therapy · 2025Article
- Cognitive Fluctuation Scale in Non-demented Patients with Parkinson's Disease.Movement disorders clinical practice · 2025Article
- Ecological validity of cognitive fluctuations in dementia with Lewy bodies.Journal of the International Neuropsychological Society : JINS · 2024Article
- Understanding the nature and impact of cognitive fluctuations and sleep disturbances in dementia with Lewy bodies: A qualitative caregiver study.SAGE open medicine · 2024Article
- A short and simple bedside test to detect cognitive fluctuations in patients with dementia with Lewy bodies.Acta neurologica Belgica · 2023Article
- Exploring the Sensitivity of Prodromal Dementia with Lewy Bodies Research Criteria.Brain sciences · 2022Article
- An Adaptive Measure of Visuospatial Impairment in Dementia with Lewy Bodies.Movement disorders clinical practice · 2022Article
- Evaluating a novel behavioral paradigm for visual hallucinations in Dementia with Lewy bodies.Aging brain · 2021Article
- Impaired sensory evidence accumulation and network function in Lewy body dementia.Brain communications · 2021Article
- Common age-related neuropathologies and yearly variability in cognition.Annals of clinical and translational neurology · 2019Article
- Dysfunctional brain dynamics and their origin in Lewy body dementia.Brain : a journal of neurology · 2019Article
- Daytime sleepiness in dementia with Lewy bodies is associated with neuronal depletion of the nucleus basalis of Meynert.Parkinsonism & related disorders · 2018Article
- Depressive symptoms are associated with daytime sleepiness and subjective sleep quality in dementia with Lewy bodies.International journal of geriatric psychiatry · 2016Article
- Sleep-disordered breathing in dementia with Lewy bodies.Current neurology and neuroscience reports · 2015Review
- Psychiatric issues in cognitive impairment.Movement disorders : official journal of the Movement Disorder Society · 2014Review
- Abnormal daytime sleepiness in dementia with Lewy bodies compared to Alzheimer's disease using the Multiple Sleep Latency Test.Alzheimer's research & therapy · 2014Article
- Cortical-subcortical interactions in hypersomnia disorders: mechanisms underlying cognitive and behavioral aspects of the sleep-wake cycle.Frontiers in neurology · 2014Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
Fluctuations in mental status are 1 of the core diagnostic criteria for dementia with Lewy bodies (DLB) and are thought to reflect variability in daytime alertness. Previous attempts to study fluctuations have been limited to caregiver reports, observer rating scales, short segments of electroencephalography, or motor-dependent, reaction time tests. Concordance among such measures is often poor, and fluctuations remain difficult to quantify. We compared fluctuations in cognition and alertness in patients with DLB (n = 13) and idiopathic Parkinson's disease (PD) (n = 64), a condition associated with deficits in daytime alertness. We systematically and repeatedly collected cognitive and physiologic measures during a 48-hour inpatient protocol in a sound-attenuated sleep laboratory in a geriatric hospital. Cognitive fluctuations were analyzed using coefficients of variation (COVs) derived from performance on a bedside examination familiar to clinicians (digit span). Alertness fluctuations were assessed objectively using COVs from the polysomnographically-based Maintenance of Wakefulness Test. Despite predictably lower mean digit span performances, DLB patients demonstrated significantly greater cognitive fluctuations than PD patients (P < 0.001), even when groups were matched on general cognitive impairment. There were no group differences in alertness fluctuations, although DLB patients were less alert than PD patients not receiving dopaminergics. The prevailing assumption that fluctuations in cognition in DLB are reflected in fluctuations in daytime alertness was not supported by objective, physiological measurements. Fluctuating mental status in DLB patients can be detected with repeated administration of a simple bedside exam that can be adapted to a clinic setting.
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