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

Joan M. Griffin, Lauren R. Bangerter, Kyungmin Kim, Yin Liu, Alexander Batthyány, Robyn W. Birkeland, Terry L. Frangiosa, Rachel L. Nosheny, Joseph Gaugler, Maria I. Lapid

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction Alzheimer's disease and related dementias (ADRD) are conditions with progressive cognitive decline. Still, people living with late-stage ADRD (PLWD) have been reported to exhibit transient recovery of communication or behavioural abilities that had seemingly been lost. These lucid episodes (LEs) are underinvestigated and poorly understood. This study aims to advance scientific understanding of the incidence, prevalence and predictors of LEs and assess from family caregivers if LEs are associated with changes they make in care planning or experiences with burden, distress or grief. Methods This study recruited 545 caregivers from five ADRD-related registries in the USA. Eligibility included caregivers over 18 years who currently provide care to someone with moderate to very severe ADRD and can complete online questionnaires. Using a longitudinal observational study design, consented caregivers will be assessed monthly for 1 year using online questionnaires that inquire about witnessing LEs. If witnessed, the context and content of the LE is reported. Changes in caregiver decision-making about care for the PLWD, and caregiver burden, distress and grief are assessed at baseline, 6 and 12 months. Analysis Analysis of baseline data will assess descriptive aspects of LEs that are currently unknown (eg, prevalence, content, antecedents, duration). Longitudinal analysis will examine the incidence of LEs, characteristics of PLWD and caregivers that are predictors of episodes, and the associations between LEs and caregiver outcomes (eg, burden, distress, grief). Ethics and dissemination This study is being conducted in accordance with all Federal Policies for the Protection of Human Subjects. The protocol has been approved by the Mayo Clinic Institutional Review Board (ID 22-006861). Findings will be presented at scientific conferences and disseminated through journal publications and outreach efforts with collaborating partners invested in brain health and caregiver support.

Original languageEnglish (US)
Article numbere098182
JournalBMJ open
Volume15
Issue number7
DOIs
StatePublished - Jul 10 2025

Bibliographical note

Publisher Copyright:
© 2025 Author(s) (or their employer(s)). Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.

Keywords

  • Caregivers
  • Delirium & cognitive disorders
  • Dementia
  • Observational Study

PubMed: MeSH publication types

  • Clinical Trial Protocol
  • Journal Article

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