Mechanism of Disorientation in Alzheimer’s Disease

Vol. 52, No. 4, 2004

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Original Paper

Mechanism of Disorientation in Alzheimer's Disease
Sabine Joray^a, François Herrmann^b, Reinhild Mulligan^a, Armin Schnider^c

^aMemory Clinic, Department of Geriatrics, Departments of
^bGeriatrics and
^cRehabilitation, Geneva University Hospitals, Geneva, Switzerland

Address of Corresponding Author

Eur Neurol 2004;52:193-197 (DOI: 10.1159/000082034)

Key Words

Disorientation
Alzheimer's disease
Dementia
Temporal context confusion
Amnesics

Abstract

In nondemented amnesics, disorientation mostly reflects a failure to select memories that pertain to ongoing reality (increased temporal context confusion; TCC), a failure strongly associated with orbitofrontal damage. In the present study, we used the same paradigm - 2 runs of a continuous recognition task - in 23 patients with mild to moderate Alzheimer's disease (AD) (Clinical Dementia Rating Scale score of 1-2). We found that disorientation was frequent in this sample (52%). However, although it correlated moderately well with general measures of dementia severity, verbal episodic memory and executive functioning, there was no significant correlation with TCC. Thus, disorientation in AD appears to reflect general cognitive decline rather than a specific cognitive failure such as increased TCC. This finding is compatible with the different distribution of degeneration in AD and the orbitofrontal damage typically present in severely disoriented amnesics.

Author Contacts

Prof. Armin Schnider, MD
Service de Rééducation, Hôpitaux universitaires de Genève
26, avenue de Beau-Séjour
CH-1211 Genève 14 (Switzerland)
Tel. +41 22 382 37 01, Fax +41 22 382 37 05, E-Mail Armin.Schnider@hcuge.ch

Article Information

Received: April 29, 2004
Accepted: September 2, 2004
Published online: November 10, 2004
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 1, Number of References : 31

Medline Abstract (ID 15539771)

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