{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T06:56:56Z","timestamp":1784357816709,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,9,22]],"date-time":"2017-09-22T00:00:00Z","timestamp":1506038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Geriat Psychiatry"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Cognitive fluctuations (CFs) occur commonly in dementia of all types. While it is generally accepted that CFs can affect the clinical rating of dementia severity and neuropsychological performance, little is known about their impact on patients' activities of daily living (ADLs) and quality of life (QOL). Our study aims to explore the impact of CFs on ADLs and QOL among institutionalized patients with dementia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The present study examined the nature and frequency of CFs in 55 institutionalized dementia patients. We used the Dementia Cognitive Fluctuation Scale (DCFS) to assess the presence and severity of CFs. The Alzheimer's Disease Functional Assessment of Change Scale (ADFACS) was used to assess patients' ADLs, and the Quality of Life in Late Stage Dementia scale (QUALID) was used to assess QOL. Linear regression models were used to assess the relationships between CFs, ADLs, and QOL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the patients was 90.41\u00a0years (SD\u00a0=\u00a02.84). Their mean Aggressive Behavior Scale score was 1.13 (SD\u00a0=\u00a01.59), mean Severe Impairment Battery total score was 86.65 (SD\u00a0=\u00a013.77), and mean DCFS score was 10.07 (SD\u00a0=\u00a03.04)<jats:bold>.<\/jats:bold> The mean ADFACS\u2010ADL score was 10.88 (SD\u00a0=\u00a06.37), mean ADFACS\u2010IADL score was 16.61 (SD\u00a0=\u00a09.54), and mean QUALID total score was 18.25 (SD\u00a0=\u00a05.70). DCFS significantly predicted ADFACS\u2010ADL score (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.39, <jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a00.30, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.011) although the relationship between ADFACS\u2010IADL score and DCFS score was not significant (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.16, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.111). DCFS significantly predicted QUALID score (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.08, <jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a00.29, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.033).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>More severe CFs in patients with dementia were significantly associated with impaired ability to engage in ADLs and poorer QOL.<\/jats:p><\/jats:sec>","DOI":"10.1002\/gps.4788","type":"journal-article","created":{"date-parts":[[2017,9,22]],"date-time":"2017-09-22T10:12:56Z","timestamp":1506075176000},"source":"Crossref","is-referenced-by-count":40,"title":["The association between cognitive fluctuations and activities of daily living and quality of life among institutionalized patients with dementia"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2024-2923","authenticated-orcid":false,"given":"Meng","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Psychiatry, The Second Xianga Hospital, Central South University; National Clinical Research Center on Mental Health Disorders (Xiangya); National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan; Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University  China"},{"name":"Division of Geriatric Psychiatry, Department of Psychiatry, Sunnybrook Health Sciences Centre; Department of Psychiatry, University of Toronto  Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J.","family":"Mainland","sequence":"additional","affiliation":[{"name":"Department of Psychology Ryerson University  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tisha J.","family":"Ornstein","sequence":"additional","affiliation":[{"name":"Department of Psychology Ryerson University  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasha","family":"Mallya","sequence":"additional","affiliation":[{"name":"Department of Psychology Ryerson University  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra J.","family":"Fiocco","sequence":"additional","affiliation":[{"name":"Department of Psychology Ryerson University  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwen Li","family":"Sin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6558-5770","authenticated-orcid":false,"given":"Kenneth I.","family":"Shulman","sequence":"additional","affiliation":[{"name":"Division of Geriatric Psychiatry, Department of Psychiatry, Sunnybrook Health Sciences Centre; Department of Psychiatry, University of Toronto  Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Herrmann","sequence":"additional","affiliation":[{"name":"Division of Geriatric Psychiatry, Department of Psychiatry, Sunnybrook Health Sciences Centre; Department of Psychiatry, University of Toronto  Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181ca017d"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2012.09.015"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2013.01.072"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.2823"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.54.8.1616"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awm322"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2005.04.002"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhu220"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.368"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-12-208"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acn.2006.03.007"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890423349"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2008.02048.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.2.3.298"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1994.00540130067012"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-0167.46.3.325"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000350800"},{"key":"e_1_2_9_19_1","first-page":"114","article-title":"The quality of life in late\u2010stage dementia (QUALID) scale","volume":"1","author":"Weiner MF","year":"2000","journal-title":"J Am Med Dir Assoc"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0018082"},{"key":"e_1_2_9_21_1","first-page":"495","article-title":"Age\u2010related cognitive decline during normal aging: The complex effect of education","volume":"15","author":"Ardila A","year":"2000","journal-title":"Arch Clin Neuropsychol"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0594.2011.00730.x"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000110246"},{"key":"e_1_2_9_24_1","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1176\/ajp.2007.164.6.910","article-title":"Nursing home placement, day care use, and cognitive decline in Alzheimer's disease","volume":"164","author":"Wilson RS","year":"2007","journal-title":"Am J Psychiatry"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/alzrt48"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2011.08.006"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-010-5453-3"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0b013e318065c4a9"}],"container-title":["International Journal of Geriatric Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fgps.4788","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/gps.4788","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T12:16:21Z","timestamp":1694952981000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/gps.4788"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,22]]},"references-count":27,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1002\/gps.4788"],"URL":"https:\/\/doi.org\/10.1002\/gps.4788","archive":["Portico"],"relation":{},"ISSN":["0885-6230","1099-1166"],"issn-type":[{"value":"0885-6230","type":"print"},{"value":"1099-1166","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,22]]}}}