{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T14:03:37Z","timestamp":1783001017713,"version":"3.54.5"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T00:00:00Z","timestamp":1763856000000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R21AG069767"],"award-info":[{"award-number":["R21AG069767"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R33AG069767"],"award-info":[{"award-number":["R33AG069767"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Lucid episodes (LEs) in advanced dementia are characterized by spontaneous, transient recovery of functional abilities. Despite recent increases in research on this previously understudied phenomenon, standard definitional criteria are lacking, presenting challenges for research. Researchers have proposed a preliminary framework to guide uniform labeling and operationalization of salient data elements for investigating LEs and developing definitional criteria. This study leverages this framework to characterize reports of LEs from caregivers and advance their definition and measurement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Design and Methods<\/jats:title>\n                    <jats:p>Family caregivers (N\u2009=\u2009259) completed an electronic survey with quantitative and open-ended questions about LEs they witnessed (N\u2009=\u2009479 episodes). Respondents were purposively sampled for qualitative interviews. Open-ended question responses (n\u2009=\u2009208) and in-depth interviews (n\u2009=\u200924) were analyzed using content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Caregiver descriptions suggest that the content and context of LEs are heterogeneous. Descriptions included observable changes from baseline, with behavior or communication that was distinguishable from routine cognitive fluctuations. LEs were sometimes, but not always specified by logically organized actions; recognition or awareness of people, emotions, and surroundings; and insight of their cognitive limitations. Many LEs required deep personal knowledge to attribute it as a meaningful shift.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Implications<\/jats:title>\n                    <jats:p>Findings suggest that definitional features may universally specify a significant return of ability with more flexible criteria for how this return manifests in observed actions and domains of recovery (i.e., insight, function, and communication). The impact of LEs on observers may be better measured separately, although further research should explore this.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/geront\/gnaf282","type":"journal-article","created":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T13:04:04Z","timestamp":1763816644000},"source":"Crossref","is-referenced-by-count":1,"title":["Lucid episodes in people with advanced dementia: characterizing caregiver reports to advance definition and measurement of episodes"],"prefix":"10.1093","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8120-3229","authenticated-orcid":false,"given":"Joan M","family":"Griffin","sequence":"first","affiliation":[{"name":"Kern Center for the Science of Healthcare Delivery, Mayo Clinic , Rochester, Minnesota,","place":["United States"]},{"name":"Division of Health Care Delivery Research, Mayo Clinic , Rochester, Minnesota,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8452-2495","authenticated-orcid":false,"given":"Lauren R","family":"Bangerter","sequence":"additional","affiliation":[{"name":"Health Economics and Aging Research Institute, MedStar Health Research Institute , Columbia, Maryland,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0135-4367","authenticated-orcid":false,"given":"Kyungmin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Child Development and Family Studies, Seoul National University , Seoul,","place":["Korea"]},{"name":"Integrated Major in Regional Studies and Spatial Analytics , Seoul,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria I","family":"Lapid","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology, Mayo Clinic , Rochester, Minnesota,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Finnie","sequence":"additional","affiliation":[{"name":"Kern Center for the Science of Healthcare Delivery, Mayo Clinic , Rochester, Minnesota,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Human Development and Family Studies, Utah State University , Logan, Utah,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4797-485X","authenticated-orcid":false,"given":"Joseph E","family":"Gaugler","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Minnesota , Minneapolis, Minnesota,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Batthy\u00e1ny","sequence":"additional","affiliation":[{"name":"Research Institute for Theoretical Psychology and Personalist Studies, P\u00e1zm\u00e1ny P\u00e9ter University , Budapest,","place":["Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry L","family":"Frangiosa","sequence":"additional","affiliation":[{"name":"UsAgainstAlzheimer\u2019s , Washington, District of Columbia,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Gilmore-Bykovskyi","sequence":"additional","affiliation":[{"name":"BerbeeWalsh, Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine & Public Health , Madison, Wisconsin,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,23]]},"reference":[{"key":"2025122615560603400_gnaf282-B1","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1001\/archneur.58.6.977","article-title":"Attention and fluctuating attention in patients with dementia with Lewy bodies and Alzheimer disease","volume":"58","author":"Ballard","year":"2001","journal-title":"Archives of Neurology"},{"key":"2025122615560603400_gnaf282-B2","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1097\/WAD.0000000000000621","article-title":"A Delphi approach to define lucid episodes in people living with dementia","volume":"38","author":"Bangerter","year":"2024","journal-title":"Alzheimer Disease and Associated Disorders"},{"key":"2025122615560603400_gnaf282-B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1037\/cns0000259","article-title":"Spontaneous remission of dementia before death: Results from a study on paradoxical lucidity","volume":"8","author":"Batthy\u00e1ny","year":"2021","journal-title":"Psychology of Consciousness: Theory, Research, and Practice"},{"key":"2025122615560603400_gnaf282-B4","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1097\/wad.0000000000000553","article-title":"The impact of episodes of lucidity on people living with dementia and their caregivers: A case report","volume":"37","author":"Benson","year":"2023","journal-title":"Alzheimer Disease and Associated Disorders"},{"key":"2025122615560603400_gnaf282-B5","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1002\/alz.12162","article-title":"Unexpected awakenings in severe dementia from case reports to laboratory","volume":"17","author":"Bostanciklio\u011flu","year":"2021","journal-title":"Alzheimer\u2019s & Dementia: The Journal of the Alzheimer\u2019s Association"},{"key":"2025122615560603400_gnaf282-B6","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1136\/jnnp.2002.002576","article-title":"Fluctuating cognition in dementia with Lewy bodies and Alzheimer\u2019s disease is qualitatively distinct","volume":"75","author":"Bradshaw","year":"2004","journal-title":"Journal of Neurology, Neurosurgery, and Psychiatry"},{"key":"2025122615560603400_gnaf282-B7","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1080\/19312458.2017.1396583","article-title":"Ten steps in scale development and reporting: A guide for researchers","volume":"12","author":"Carpenter","year":"2018","journal-title":"Communication Methods and Measures"},{"key":"2025122615560603400_gnaf282-B8","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1016\/j.jalz.2019.06.3915","article-title":"Lucidity in dementia: A perspective from the NIA","volume":"15","author":"Eldadah","year":"2019","journal-title":"Alzheimer\u2019s & Dementia: The Journal of the Alzheimer\u2019s Association"},{"key":"2025122615560603400_gnaf282-B9","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1016\/S1474-4422(15)00101-5","article-title":"The interface between delirium and dementia in elderly adults","volume":"14","author":"Fong","year":"2015","journal-title":"The Lancet. Neurology"},{"key":"2025122615560603400_gnaf282-B10","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1093\/geront\/gnac095","article-title":"\u201cIt\u2019s you\u201d: Caregiver and clinician perspectives on lucidity in people living with dementia","volume":"63","author":"Gilmore-Bykovskyi","year":"2023","journal-title":"The Gerontologist"},{"key":"2025122615560603400_gnaf282-B11","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3928\/00989134-20210326-01","article-title":"The importance of conceptualizing and defining episodes of lucidity","volume":"47","author":"Gilmore-Bykovskyi","year":"2021","journal-title":"Journal of Gerontological Nursing"},{"key":"2025122615560603400_gnaf282-B12","doi-asserted-by":"publisher","first-page":"e085897","DOI":"10.1136\/bmjopen-2024-085897","article-title":"An observational study protocol to capture, validate and characterise lucid episodes in people living with advanced dementia receiving hospice care","volume":"14","author":"Gilmore-Bykovskyi","year":"2024","journal-title":"BMJ Open"},{"key":"2025122615560603400_gnaf282-B13","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1002\/alz.12709","article-title":"Toward harmonization of strategies for investigating lucidity in AD\/ADRD: A preliminary research framework","volume":"19","author":"Gilmore-Bykovskyi","year":"2023","journal-title":"Alzheimer\u2019s and Dementia"},{"key":"2025122615560603400_gnaf282-B14","doi-asserted-by":"publisher","first-page":"2434","DOI":"10.1002\/alz.13667","article-title":"Developing and describing a typology of lucid episodes among people with Alzheimer\u2019s disease and related dementias","volume":"20","author":"Griffin","year":"2024","journal-title":"Alzheimer\u2019s & Dementia: The Journal of the Alzheimer\u2019s Association"},{"key":"2025122615560603400_gnaf282-B15","doi-asserted-by":"publisher","first-page":"gnad170","DOI":"10.1093\/geront\/gnad170","article-title":"Caregiver accounts of lucid episodes in persons with advanced dementia","volume":"64","author":"Karlawish","year":"2024","journal-title":"The Gerontologist"},{"key":"2025122615560603400_gnaf282-B16","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1136\/bmjspcare-2015-001083","article-title":"Unusual perceptions at the end of life: Limitations to the diagnosis of hallucinations in palliative medicine","volume":"7","author":"Kellehear","year":"2017","journal-title":"BMJ Supportive & Palliative Care"},{"key":"2025122615560603400_gnaf282-B17","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1002\/nur.21768","article-title":"Characteristics of qualitative descriptive studies: A systematic review","volume":"40","author":"Kim","year":"2017","journal-title":"Research in Nursing & Health"},{"key":"2025122615560603400_gnaf282-B18","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample size in qualitative interview studies: guided by information power","volume":"26","author":"Malterud","year":"2016","journal-title":"Qualitative Health Research"},{"key":"2025122615560603400_gnaf282-B19","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1016\/j.jalz.2019.04.002","article-title":"Paradoxical lucidity: A potential paradigm shift for the neurobiology and treatment of severe dementias","volume":"15","author":"Mashour","year":"2019","journal-title":"Alzheimer\u2019s & Dementia: The Journal of the Alzheimer\u2019s Association"},{"key":"2025122615560603400_gnaf282-B20","doi-asserted-by":"publisher","first-page":"42","DOI":"10.3928\/00989134-20201106-06","article-title":"Lucidity in the context of advanced neurodegenerative disorders: A concept analysis","volume":"46","author":"Morris","year":"2020","journal-title":"Journal of Gerontological Nursing"},{"key":"2025122615560603400_gnaf282-B21","doi-asserted-by":"publisher","first-page":"264","DOI":"10.31156\/jaex.24028","article-title":"The importance of the exceptional in tackling riddles of consciousness and unusual episodes of lucidity","volume":"2","author":"Nahm","year":"2022","journal-title":"Journal of Anomalous Experience and Cognition"},{"key":"2025122615560603400_gnaf282-B22","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1097\/NMD.0b013e3181c22583","article-title":"Terminal lucidity in patients with chronic schizophrenia and dementia: A survey of the literature","volume":"197","author":"Nahm","year":"2009","journal-title":"The Journal of Nervous and Mental Disease"},{"key":"2025122615560603400_gnaf282-B23","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.archger.2011.06.031","article-title":"Terminal lucidity: A review and a case collection","volume":"55","author":"Nahm","year":"2012","journal-title":"Archives of Gerontology and Geriatrics"},{"key":"2025122615560603400_gnaf282-B24","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/1471-2288-9-52","article-title":"Qualitative description\u2014The poor cousin of health research?","volume":"9","author":"Neergaard","year":"2009","journal-title":"BMC Medical Research Methodology"},{"key":"2025122615560603400_gnaf282-B25","volume-title":"Qualitative research and evaluation methods","author":"Patton","year":"2014","edition":"4th"},{"key":"2025122615560603400_gnaf282-B26","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1002\/alz.12579","article-title":"Is there a difference between terminal lucidity and paradoxical lucidity?","volume":"18","author":"Peterson","year":"2022","journal-title":"Alzheimer\u2019s & Dementia: The Journal of the Alzheimer\u2019s Association"},{"key":"2025122615560603400_gnaf282-B27","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1002\/alz.12424","article-title":"What is paradoxical lucidity? The answer begins with its definition","volume":"18","author":"Peterson","year":"2022","journal-title":"Alzheimer\u2019s & Dementia: The Journal of the Alzheimer\u2019s Association"},{"key":"2025122615560603400_gnaf282-B28","doi-asserted-by":"publisher","first-page":"2395","DOI":"10.1080\/13607863.2023.2207167","article-title":"Unexpected lucidity in dementia: application of qualitative methods to develop an informant-reported lucidity measure","volume":"27","author":"Ramirez","year":"2023","journal-title":"Aging & Mental Health"},{"key":"2025122615560603400_gnaf282-B29","doi-asserted-by":"publisher","first-page":"afae174","DOI":"10.1093\/ageing\/afae174","article-title":"The lucidity in dementia experience: perspectives from family and professional caregivers","volume":"53","author":"Ramirez","year":"2024","journal-title":"Age and Ageing"},{"key":"2025122615560603400_gnaf282-B30","doi-asserted-by":"publisher","first-page":"1819","DOI":"10.1177\/14713012231200622","article-title":"Exploring why \u201cmemory loss\u201d is a misleading descriptor of people living with dementia and can lead to dysfunctional care","volume":"22","author":"Sabat","year":"2023","journal-title":"Dementia (London, England)"},{"key":"2025122615560603400_gnaf282-B31","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1002\/1098-240x(200008)23:4%3C334::aid-nur9%3E3.0.co;2-g","article-title":"Whatever happened to qualitative description?","volume":"23","author":"Sandelowski","year":"2000","journal-title":"Research in Nursing and Health"},{"key":"2025122615560603400_gnaf282-B32","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1002\/nur.20362","article-title":"What\u2019s in a name? Qualitative description revisited","volume":"33","author":"Sandelowski","year":"2010","journal-title":"Research in Nursing & Health"},{"key":"2025122615560603400_gnaf282-B33","doi-asserted-by":"publisher","first-page":"18","DOI":"10.3928\/00989134-20221206-03","article-title":"Reports about paradoxical lucidity from health care professionals: A pilot study","volume":"49","author":"Teresi","year":"2023","journal-title":"Journal of Gerontological Nursing"},{"key":"2025122615560603400_gnaf282-B34","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1038\/nrneurol.2012.135","article-title":"The paradox of syndromic diversity in Alzheimer disease","volume":"8","author":"Warren","year":"2012","journal-title":"Nature Reviews. Neurology"}],"container-title":["The Gerontologist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/gerontologist\/advance-article-pdf\/doi\/10.1093\/geront\/gnaf282\/65484075\/gnaf282.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/gerontologist\/article-pdf\/65\/12\/gnaf282\/65484075\/gnaf282.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/gerontologist\/article-pdf\/65\/12\/gnaf282\/65484075\/gnaf282.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T20:56:12Z","timestamp":1766782572000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/gerontologist\/article\/doi\/10.1093\/geront\/gnaf282\/8340580"}},"subtitle":[],"editor":[{"given":"Tonya J","family":"Roberts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,11,10]]},"references-count":34,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,11,10]]}},"URL":"https:\/\/doi.org\/10.1093\/geront\/gnaf282","relation":{},"ISSN":["0016-9013","1758-5341"],"issn-type":[{"value":"0016-9013","type":"print"},{"value":"1758-5341","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12]]},"published":{"date-parts":[[2025,11,10]]},"article-number":"gnaf282"}}