Disorientation in Time and Place in Old Age: Longitudinal Evidence from Three Old Age Cohorts in Germany (AgeDifferent.de Platform).

ABSTRACT

BACKGROUND: Only little evidence is available on disorientation, one of the most challenging symptoms of Alzheimer's disease and related dementias. OBJECTIVES: The aim of this study was to investigate the prevalence of disorientation in older age in association with the level of cognitive status, personal characteristics, and life events. METHODS: Three longitudinal population-based cohort studies on cognitive health of elderly adults were harmonized (LEILA 75 + , AgeCoDe/AgeQualiDe, AgeMooDe). Participants who completed a baseline and at least one follow-up assessment of cognitive functioning and who did not have stroke, Parkinson's disease, atherosclerosis, kidney disease, and/or alcoholism were included in the analysis (n = 2135, 72.6% female, mean age 80.2 years). Data was collected in standardized interviews and questionnaires with the participant, a proxy informant, and the participant's general practitioner. RESULTS: Making three errors in the MMSE other than in the questions on orientation (MMSEwo) came with a probability of 7.8% for disorientation, making ten errors with a probability of 88.9%. A lower MMSEwo score (HR 0.75, CI 95 0.71-0.79, p < 0.001), older age (HR 1.11, CI 95 1.08-1.14, p < 0.001), and living in a nursing home (HR 1.64, CI 95 1.02-2.64, p = 0.042) were associated with incident disorientation. Impairments in walking (OR 2.41, CI 95 1.16-4.99, p = 0.018) were associated with a greater probability for prevalent disorientation. None of the life events were significant. CONCLUSION: Our findings suggest that disorientation is primarily associated with cognitive status. Regular walking activities might possibly reduce the risk for disorientation but further research is necessary.