Lucidity is the transient recovery of abilities and communication that were seemingly lost among people living with dementia (PLWD). This study describes lucid episodes reported by Alzheimer’s dementia (AD) and Lewy Body Dementias (LBD) caregivers. We analyzed survey data from 212 current AD (n = 191) and LBD caregivers who reported the frequency, duration, and characteristics of 653 lucid episodes witnessed in the past month.
Major Findings
Most AD caregivers (67%) and LBD caregivers (81%) witnessed a lucid episode within the past month. LBD caregivers reported lucid episodes with greater changes in awareness and communication, compared to AD caregivers. LBD caregivers reported longer lucid episodes and that the PLWD knew about their change in lucidity, compared to AD caregivers.
Conclusions
Findings suggest that differences in lucid episode intensity, timing, and meta-awareness between AD and LBD are possible and may inform care strategies for PLWD.
HoganDBFiestKMRobertsJI, et al. The prevalence and incidence of dementia with Lewy bodies: a systematic review. Can J Neurol Sci. 2016;43(S1):S83-S95. doi:10.1017/cjn.2016.2
BradshawJSalingMHopwoodM, et al. Fluctuating cognition in dementia with Lewy bodies and Alzheimer’s disease is qualitatively distinct. J Neurol Neurosurg Psychiatry. 2004;75(3):382-387. doi:10.1136/jnnp.2002.002576
4.
BallardCO'BrienJGrayA, et al.Attention and fluctuating attention in patients with dementia with Lewy bodies and Alzheimer disease. Arch Neurol. 2001;58(6):977-982. doi:10.1001/archneur.58.6.977.
5.
McKeithIGBoeveBFDicksonDW, et al. Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB consortium. Neurology. 2017;89(1):88-100. doi:10.1212/WNL.0000000000004058
6.
LeeDRTaylorJ-PThomasAJ. Assessment of cognitive fluctuation in dementia: a systematic review of the literature. Int J Geriatr Psychiatry. 2012;27(10):989-998. doi:10.1002/gps.2823
7.
EldadahBAFazioEMMcLindenKA. Lucidity in dementia: a perspective from the NIA. Alzheimer’s Dement. 2019;15(8):1104-1106. doi:10.1016/j.jalz.2019.06.3915.
8.
MashourGAFrankLBatthyanyA, et al.Paradoxical lucidity: a potential paradigm shift for the neurobiology and treatment of severe dementias. Alzheimer’s Dement. 2019;15(8):1107-1114. doi:10.1016/j.jalz.2019.04.002.
9.
Gilmore-BykovskyiAGriffinJMMuellerKD, et al. Toward harmonization of strategies for investigating lucidity in AD/ADRD: a preliminary research framework. Alzheimer’s Dement. 2023;19(1):343-352. doi:10.1002/alz.12709
10.
GriffinJMKimKFinnieDM, et al. Developing and describing a typology of lucid episodes among people with Alzheimer’s disease and related dementias. Alzheimer’s Dement. 2024;20(4):2434-2443. doi:10.1002/alz.13667
11.
KarlawishJPetersonAKleidM, et al. Caregiver accounts of lucid episodes in persons with advanced dementia. Gerontologist. 2024;64(6):gnad170. doi:10.1093/geront/gnad170
12.
RamirezMTeresiJASilverS, et al. The lucidity in dementia experience: perspectives from family and professional caregivers. Age Ageing. 2024;53(8):afae174. doi:10.1093/ageing/afae174
13.
Gilmore-BykovskyiABlockLBensonC, et al. “It’s You”: caregiver and clinician perspectives on lucidity in people living with dementia. Gerontologist. 2022;63(1):13-27. doi:10.1093/geront/gnac095
14.
GriffinJMBangerterLRKimK, et al. Lucid episodes in people with advanced dementia: characterizing caregiver reports to advance definition and measurement of episodes. Gerontologist. 2025;65(12):gnaf282. doi:10.1093/geront/gnaf282
15.
GriffinJMBangerterLRKimK, et al. Lucid episodes among people with Alzheimer’s disease and related dementias and their impact on family caregiver stress and grief (LEAD): protocol for a longitudinal observational study. BMJ Open. 2025;15(7):e098182. doi:10.1136/bmjopen-2024-098182
16.
KatzSFordABMoskowitzRW, et al. Studies of illness in the aged. The index of adl: a standardized measure of biological and psychosocial function. JAMA. 1963;185:914-919. doi:10.1001/jama.1963.03060120024016
17.
LawtonMPBrodyEM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontolosist. 1969;9(3_Part_1):179-186. doi:10.1093/geront/9.3_Part_1.179
18.
MoserAStuckAESillimanRA, et al. The eight-item modified medical outcomes study social support survey: psychometric evaluation showed excellent performance. J Clin Epidemiol. 2012;65(10):1107-1116. doi:10.1016/j.jclinepi.2012.04.007
19.
LiangK-YZegerSL. Longitudinal data analysis using generalized linear models. Biometrika. 1986;73:13-22. doi:10.1093/biomet/73.1.13
20.
McNeishD. A practical guide to selecting and blending approaches for clustered data: clustered errors, multilevel models, and fixed-effect models. Psychol Methods. 2026;31(2):225-251. doi:10.1037/met0000620
21.
GrissomRJKimJJ. Effect Sizes for Research: Univariate and Multivariate Applications. Routledge; 2012.
22.
LakensD. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol. 2013;4:863. doi:10.3389/fpsyg.2013.00863
23.
CohenJ. Statistical Power Analysis for the Behavioral Sciences. Routledge; 1988.
24.
MehtaRISchneiderJA. Neuropathology of the common forms of dementia. Clin Geriatr Med. 2023;39(1):91-107. doi:10.1016/j.cger.2022.07.005.
25.
HuangW-CChangM-CWangW-F, et al. A comparison of caregiver burden for different types of dementia: an 18-month retrospective cohort study. Front Psychol. 2022;12:798315. doi:10.3389/fpsyg.2021.798315
26.
MorrisPBulmanD. Lucidity in the context of advanced neurodegenerative disorders: a concept analysis. J Gerontol Nurs. 2020;46(12):42-50. doi:10.3928/00989134-20201106-06.
27.
SternY. Cognitive reserve in ageing and Alzheimer’s disease. Lancet Neurol. 2012;11(11):1006-1012. doi:10.1016/S1474-4422(12)70191-6.
28.
AlexanderCMMartyrAClareLIDEAL Programme Research Team. Changes in awareness of condition in people with mild-to-moderate dementia: longitudinal findings from the IDEAL cohort. Int J Geriatr Psychiatry. 2022;37(4). doi:10.1002/gps.5702
29.
ElderGJLazarASAlfonso-MillerP, et al. Sleep disturbances in Lewy body dementia: a systematic review. Int J Geriatr Psychiatry. 2022;37(10). doi:10.1002/gps.5814
30.
GriffinJMKimKGauglerJE, et al. Caregiver appraisals of lucid episodes in people with late‐stage Alzheimer’s disease or related dementias. Alzheimer’s Dement: Diagn Assess Dis Monit. 2022;14(1):e12313. doi:10.1002/dad2.12313
31.
CottonQDBirkelandRBaileyD, et al. She asked if she had dementia: caregivers’ insights on lucidity in late stages of dementia and its impact. Alzheimer’s Dement: Behav Socioecon Aging. 2025;1(4):e70049. doi:10.1002/bsa3.70049
