Autonomous spatial orientation in patients with mild to moderate Alzheimer's disease by using mobile assistive devices: a pilot study.

Abstract

Spatial orientation declines early in patients with Alzheimer's disease (AD) and is a major cause for institutionalization of patients. Use of either an aerial map or an assistive device to get from start to goal zone, both located on the campus of the hospital (distance between start and goal zone 300 m to 500 m). Use of the assistive device was trained for 15 minutes prior to the task. We assessed 14 patients with mild to moderate AD (DSM-IV and NINCDS-ADRDA criteria; 9 female patients, 5 male patients; age 71.9 ± 7.4 years; MMSE 21.7 ± 2.9 (mean ± SD), range 16-26). Each patient had to find the way for three different routes with different start and goal zones. None of the patients found their way to the goal zone for any of the routes when using an aerial map in which the way was highlighted. With use of the assistive device, patients found their way from start to goal zones autonomously for 20 of 42 routes (3 routes each for 14 patients). For 22 of 42 routes intermediate re-assurance was necessary, but herewith routes were completed. This study lays ground for the use of mobile technical devices in patients with mild to moderate AD. Mobile assistive devices may enable patients with mild to moderate AD to maintain autonomous spatial orientation in unfamiliar environments. Improvement of the familiarization of patients with the device and further sophistication of assistive cues is likely to further improve autonomous use of navigational devices in patients with mild to moderate AD.