Orientation: its Contribution to a Diagnosis of Alzheimer's Disease

Christine Kennard Health Pro
  • When you suspect someone may have Alzheimer’s disease, or another type of dementia, their doctor will carry out a number of tests. One of these tests is a mental state exam and cognitive tests and they include questions to assess if they are orientated in time, place and person.


    The doctor will sometimes refer to this aspect of their assessment by saying the person is 'oriented times three'.

    • Orientated x 1 is their awareness of not only themselves but those around them. Sometimes the person knows who they are and will be able to tell you their name. However they may not know who the people are around them, for instance their relative or spouse or the doctor. In the early stages of Alzheimer’s the patient will often know both their own identity and their loved ones but as the disease progresses and the brain damage increases their disorientation does too. Self-identity seems to remain intact longer.
    • Oriented x 2 refers to their orientation on place. The doctor will ask them where they are at this moment, for instance the hospital or their own house, the country, or their State. In Alzheimer’s disease, and many other types of neurological conditions and diseases, people become confused and disorientated. As expected the familiar (their own house) will be more easily recalled than new environments but in the later stage of Alzheimer’s their recognition will go. They may tell you they live in towns or cities they lived in many years previously.
    • Oriented x 3 refers to their orientation in time. Time is in the initial stages of Alzheimer’s the most noticeable change. The person will often believe they are much younger and that it is many ago.

    Disorientation is the term we use to describe the lack of one or more of these capacities to recognise ourselves in place, time and person and is just one of the signs and symptoms of Alzheimer’s. It can also help identify the type of dementia the person has. For instance in Alzheimer’s disease orientation and memory are affected but in another type of dementia called frontotemporal dementia memory is impaired but orientation remains intact.

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    More information

    10 warning signs of Alzheimer's disease

    4 Reasons why assessment is essential for people with Alzheimer's disease

Published On: September 10, 2014