目的：許多仍居住在社區的阿茲海默氏症 (Alzheimer’s disease, AD) 病人有認路的困難，尤其在晨昏 (twilight)、起霧或是陰雨天。本研究探討極輕度AD病人在模糊或昏暗的情境下，對住家附近熟悉街景的辨識能力。
方法：邀請居住在社區之極輕度AD病人及正常控制組 (Normal controls, NC) 參與研究。街景辨識作業包含八張個人熟悉街景及八張陌生街景，為了模擬晨昏、起霧或陰雨天等視線不良的情境，將照片特效處理後分為模糊 (Low spatial frequency, LSF) 及昏暗 (Low luminance, LL) 情境。每張照片按照難度由等級10 (最困難) 呈現至等級1 (最簡單)，受試者需判斷照片是否熟悉、在何處、並描述如何認出照片。辨識正確數為受試者正確認出照片的數目，而辨識的能力則依據正確地認出照片時的等級，辨識的依據則是受試者在辨識過程中所使用的線索類型及數量。
結果：20位AD病人及20位NC受試者完成實驗，兩組的基本視力 (visual acuity) 與視空間建構能力 (visual constructional ability) 沒有差異。AD組在模糊及昏暗情境下，辨識個人熟悉街景的正確數與能力皆較NC組差。NC組較常使用整體線索 (global cues) 辨識陌生街景，而AD組亦使用整體線索來辨識熟悉街景，此結果顯示AD病人面對熟悉街景時可能將之視為陌生街景。此外，AD病人在等級漸低的辨識過程中，線索使用的累積數量低於NC組，也顯示AD病人的視覺搜索能力與線索使用效率可能受損。
結論：極輕度AD病人在模糊與昏暗情境中辨識熟悉環境的能力較差，而此能力受損可能為視覺搜索能力受損及線索使用效率較差所致。

Objective Many community-residing patients with Alzheimer disease (AD) have way-finding problems, particularly in the twilight, foggy or rainy days. In this study, we invited very mild AD patients and normal controls (NC) to test their recognition ability.
Methods The experimental samples included eight personally familiar and eight novel street scenes which were divided to Low Spatial Frequency (LSF) and Low Luminance (LL) conditions simulating nighttime, foggy or rainy days. Each was presented from the level 10 to level 1, representing the most difficult to the easiest. The participants were to judge whether the scene was familiar, and described how they did it. The accuracy was measured by number of scenes identified and the ability by the level needed.
Results Twenty AD and 20 NC subjects completed the study and their basic visual acuity was equal. The AD patients had poorer accuracy and ability to recognize familiar scenes in either LL or LSF condition. In familiar scenes section, AD patients tended to use global cues, a strategy often used by NC to judge novel scenes. This pattern indicates that these AD patients might treat their familiar scenes as novel. As the street scenes were becoming clearer or brighter, NC tended to use more cues as the accumulation rates were higher than those in AD, suggesting their possible impaired visual exploration skills and ineffective cue utilization.
Conclusion This study demonstrates that very mild AD patients have a poorer ability to recognize familiar environmental landmarks in LSF and LL conditions and probably due to impaired visual exploration skills and ineffective cue utilization.

中文部分
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