Alzheimer's Disease

Alzheimer's disease is a type of dementia that can cause people to be disoriented.

Alert and Oriented x1, x2, x3, and x4 in Dementia

https://www.verywellhealth.com/what-is-orientation-and-how-is-it-affected-by-dementia-98571 

Orientation is something healthcare providers check when screening for dementia and evaluating cognitive abilities.1

Merck Manual Professional Version. How to assess mental status.

 It refers to a person's level of awareness of self, place, time, and situation.

Healthcare providers score a person's orientation on a scale of 1 to 4. The higher the number, the better oriented a person is considered. For example, if you are fully alert and oriented, x4 will be noted.

When testing a person's orientation, a doctor asks standard questions that may seem like small talk. But these questions are useful for testing recent and longer-term memories.

Typical questions include:

What is your name?

Where are you?

What is the date?

What time is it?

What just happened to you?

This article includes information about what different levels of orientation mean and how they relate to Alzheimer's disease, dementia, and delirium.

Orientation Levels

In certain health assessments, orientation is sometimes referred to as "alert and oriented" (AO or A&O) or "awake, alert, and oriented" (AAO). It is usually followed by the multiplication symbol (x) and a number. For example, it may be written like "AOx3" or "AAOx4."

The level—x1, x2, x3, or x4—is a way of measuring the extent of a person's awareness.

Here's what the types of orientation mean:

• Oriented to person: The person knows their name and usually can recognize significant others.
• Oriented to place: The person knows where they are, such as the hospital, clinic, or town.
• Oriented to time: The person knows the time of day, date, day of the week, and season.
• Oriented to situation: They can explain why they are talking to the doctor.

Sometimes a person can answer some of this information, but not all. For example, they may know their name and the date but can't say where there are or why. In that case, it would be notated as x2.

In some circumstances, healthcare providers might only ask about person, place, and time. In that situation, x3 is the highest level of orientation tested. When a doctor includes questions about the situation, the highest level would then be x4.

In addition to the value (i.e., x3), a healthcare provider's notes should also include the specific questions asked and answers given.                                                                                                                            What Is the Memory Impairment Screen (MIS)? (verywellhealth.com)