Related Experiment Video
Updated: Aug 29, 2026

The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease
Published on: October 13, 2016
Spatial disorientation in Alzheimer's disease: the remembrance of things passed
Anthony M Monacelli1, Laura A Cushman, Voyko Kavcic
1Department of Neurology, The University of Rochester Medical Center, Rochester, NY 14642, USA.
Background:
Patients with Alzheimer's disease (AD) and many older adults become lost even in familiar surroundings. This is commonly attributed to memory impairment, but it may reflect impaired spatial cognition.
Methods:
The authors examined the role of memory, perceptual, and cognitive mechanisms in spatial disorientation by comparing the performance of normal young (YN), middle-aged (MA), older adult (OA), and AD subjects on neuropsychological and spatial orientation tests.
Results:
The tendency to become lost is shared by almost all patients with AD (93%) and some OA subjects (38%). This impairment is not related to memory impairment. Instead, it reflects an inability to link recognized scenes with locations in the environment.
Conclusions:
Spatial disorientation reflects the impaired linking of landmarks and routes that should be assessed in conjunction with routine memory testing in elderly patients.
Related Concept Videos
Dementia l: Introduction
Amnesia
The severity and duration of memory loss vary depending on the type and underlying cause. Amnesia is classified into two main types: retrograde and anterograde.
Retrograde amnesia is marked by the loss of memories formed before the onset of the condition. Patients may recall distant past events but often forget those occurring shortly before the incident.
Anterograde...
Alzheimer Disease l: Introduction
Alzheimer Disease ll: Pathophysiology
Alzheimer's Disease: Overview
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ and tau...
Role of Hippocampus in Memory

