Spatial disorientation in Alzheimer's disease - The remembrance of things passed

Background: Patients with Alzheimer's disease ( AD) and many older adults become lost even in familiar surroundings. This is commonly attributed to memory impairment, but it may reflect impaired spatial cognition. Methods: The authors examined the role of memory, perceptual, and cognitive mechanisms in spatial disorientation by comparing the performance of normal young ( YN), middle- aged ( MA), older adult ( OA), and AD subjects on neuropsychological and spatial orientation tests. Results: The tendency to become lost is shared by almost all patients with AD ( 93%) and some OA subjects ( 38%). This impairment is not related to memory impairment. Instead, it reflects an inability to link recognized scenes with locations in the environment. Conclusions: Spatial disorientation reflects the impaired linking of landmarks and routes that should be assessed in conjunction with routine memory testing in elderly patients.