Discussion
dementia
EVENTS, DISEASES
To the best of our knowledge, this will be the first study evaluating the health state fluctuations in dementia diseases using a daily diary to document the change in today's health compared to the day before over 14 days. This study may reveal important insights into the frequency and intensity of health state fluctuations in dementia, the affected dimensions and underlying health events. Analogous to the findings of Sun et al. (The information generated from this mixed-methods study can also be vital to inform future research to test modified recall periods of the EQ-5D-5L in PlwD or other fluctuating cyclical health state conditions. The results of this study could make a highly relevant first contribution to more accurate measurements and, thus, give a better understanding of the HRQoL of PlwD. A better understanding of the influences of health state fluctuations on the EQ-5D-5L will make generic PROMs in cyclical health conditions more reliable and generalizable. It will propose a hypothesis on better recall and testing periods for the EQ-5D-5L and other PROMS. Furthermore, the additional information on the presence of fluctuations, the influence of the one-day capture of the EQ-5D-5L and potential changes in this measure necessary to better integrate such information may help to increase the treatment and counseling of patients and their caregivers.