The Japanese journal of neuropsychology

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ArticleTitle	Short Fluctuations Questionnaire (SFQ): a study for the content validity of each item and for the construct validity in each dementia or other cognitive dysfunction
Language	J
AuthorList	Shiori Shimizu¹⁾, Atsuko Nagashima²⁾, Chie Ichino³⁾⁴⁾, Takuya Sato⁵⁾, Toru Imamura¹⁾⁴⁾
Affiliation	¹⁾Department of Speech Therapy, School of Health Sciences, Niigata University of Health and Welfare ²⁾Department of Rehabilitation, Hitachi General Hospital ³⁾Living Support Oyama Multifunctional Community-based Facility ⁴⁾Department of Neurology, Niigata Rehabilitation Hospital ⁵⁾Division of Speech Therapy, Department of Rehabilitation, Niigata Rehabilitation Hospital
Publication	Japanese Journal of Neuropsychology: 28 (2), 151-159, 2012
Received	Feb 14, 2011
Accepted	Jul 5, 2011
Abstract	Objective: To evaluate the content validity of each item composing the Short Fluctuations Questionnaire (SFQ: Oguri et al., 2006; Ichino et al., 2007; Nagashima et al., 2009), a structured interview for cognitive fluctuation in dementia with Lewy bodies (DLB), and to evaluate the construct validity of the SFQ in each dementia or other cognitive dysfunction. Subjects: 110 patients with Alzheimer's disease (AD), 24 DLB patients, 12 patients with frontotemporal dementia (FTD), 7 patients with vascular dementia (VD), 8 patients with cognitive dysfunction as a sequela of cerebral infarction, 7 patients with cognitive dysfunction as a sequela of cerebral contusion, and 6 patients with mild cognitive impairment. In this study, a DLB patient was defined as a patient who had both of the following: 1) clinical dementia and 2) visual hallucination, motor parkinsonism or both. A behavioral neurologist, who was independent to the SFQ, classified each AD or DLB patient's cognitive fluctuation as "positive" or "negative". Methods: The SFQ was administered to the reliable informant of each patient by speech therapists at the first visit of each patient. For 8 items of the SFQ, the sensitivity and specificity were assessed in the DLB and the AD patients and in the patient groups of "positive" and the "negative" fluctuation. The validity of the SFQ total scores was evaluated in other types of dementias and other cognitive dysfunction. Results: Each of 8 items showed sufficiently high sensitivity or specificity. The rates of patients who scored above the cut-off point for cognitive fluctuation were high in the patient groups of FTD, cerebral contusion, VD, and cerebral infarction. Conclusion: The validity was confirmed in each item of the SFQ. Scores above the cut-off point were often observed in the patients with posttraumatic or cerebrovascular delirium and the patients with frontal lobe syndrome. Therefore, the SFQ is a useful clinical tool for detecting the cognitive fluctuation in DLB after the differential diagnosis for eliminating the patients with delirium or frontal lobe syndrome.
Keywords	cognitive fluctuation, dementia with Lewy bodies, frontotemporal dementia, frontal lobe syndrome, delirium