Risk for disorientation: Longitudinal evidence from three old‐age cohorts in Germany (AgeDifferent.de): Epidemiology / Risk and protective factors in MCI and dementia

Background Only little evidence is available on disorientation, one of the most challenging symptoms of Alzheimer’s disease and related dementias (ADRD). Aim of this study was to investigate the occurrence of disorientation in association with the level of cognitive functioning, personal characteristics, and specific life events. Method Three population‐based longitudinal cohort studies on cognitive health of elderly adults in Germany were harmonized (AgeDifferent.de platform: LEILA 75+, AgeCoDe/AgeQualiDe, AgeMooDe). Data on cognition, personal characteristics, and life events were collected in standardized interviews and questionnaires with the participant, a proxy informant, and the participant’s general practitioner. Participants who completed the cognitive assessments at follow‐up and who did not have stroke, Parkinson’s, atherosclerosis, kidney infection/disease, and/or alcoholism were included in the analysis (n=2135). Result Older age, a lower MMSE score (without the disorientation items), impairments in walking and being divorced or widowed came with a greater likelihood of having disorientation. Incident disorientation over the study period was predicted by older age, a lower MMSE score (without the disorientation items) and living in a nursing home. Of the life events that we investigated, only the event ‘moving’ was significantly associated with a greater likelihood of incident disorientation. Subgroub analyses for dementia patients emphasize the relevance of certain cognitive deficits. Conclusion Clinicians and health care workers should be aware that elderly people with decreased cognitive functioning who have difficulties walking, disrupted family relationships, and are in the process of moving to a new home are more likely to experience disorientation. More research is needed to identify specific situations that trigger disorientation at certain stages of dementia.