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Updated: Aug 25, 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
Visuospatial inattention and daily life performance in people with Alzheimer's disease
Chiung-ju Liu1, Joan McDowd, Keh-chung Lin
1Department of Gerontology, University of Kansas, 1000 Sunnyside Avenue, Lawrence, Kansas 66045, USA. liu_chiung_ju@hotmail.com
Objective:
The purpose of this study was to examine the relationship between visual inattention and daily life performance in people with Alzheimer's disease.
Methods:
Twenty persons with Alzheimer's disease (Mini Mental Status Exam [MMSE] > 20) and 21 community dwelling persons (MMSE > 26) voluntarily participated in this study. One line bisection test and two cancellation tests were used for testing attention abilities. The Functional Spatial Abilities Questionnaire (FSAQ), the Disability Assessment for Dementia (DAD), and the behavioral subtests of the Behavioral Inattention Test (BIT) were used to assess daily functioning. The presence of visuospatial neglect in people with Alzheimer's disease was determined by comparing performance on the three attention tests with the control group.
Results:
People with Alzheimer's disease who omitted more targets on the symbol cancellation test showed more deficits on the behavioral subtests of the BIT (p = .02). They also used less systematic searching strategies (p = .001), spent more time looking for targets (p = .001), and made more commission errors (p = .007) than controls on the cancellation test. However, those with Alzheimer's disease who had visuospatial neglect did not differ from those without neglect on the FSAQ, DAD, and most of the BIT behavioral subtests.
Conclusion:
People with Alzheimer's disease have visual inattention problems; however, visuospatial neglect did not interfere with their performance in daily activities as measured in this study. Further research focusing on the relationship between visual attention and daily life function as the disease progresses is suggested.
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