The assessment of orientation in dementia: Item content versus item format

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AbstractOrientation assessments with regard to time, place and person tend to show a typical pattern of deterioration in progressive dementias. Some clinicians have established hierarchies of orientation based on these observed paterns. There are discrepancies in the order of these hierarchies, due perhaps to differences in the phrasing of questions asked of patients. It is possible to vary the difficulty of items by changing the question format and evidence is cited to show that format differences may be especially pertinent to demented populations. In two large samples of psychogeriatric subject frequencies of incorrect responses for individual orientation items were calculated along with probabilities of success based on chance responding. Results show that although the traditional contentbased hierarchy was observed, simple probabilities of success could also account for the observed frequencies of incorrect responding.