2026 Volume 46 Issue 4 Pages 251-263
Background：Alzheimer’s disease (AD) is a neurodegenerative condition which has been associated with impairments in time perspective, including cognitions of the past, present, and future. This study aimed to clarify how patients with AD recognize time perspective and its relationships with other cognitive functions.
Methods：This study enrolled 30 patients with AD, 16 with mild cognitive impairment (MCI), and 14 without AD. All patients were enrolled from neurology memory clinics. Cognitive function was assessed using the Japanese version of the Mini-Mental State Examination (MMSE-J). Time perspective was assessed using the Circle Test, a projective drawing test. In this test, participants used circles to draw their views of the past, present, and future on paper, with the size and position of the circles reflecting their time perspectives. We evaluated qualitative characteristics (e.g., the largest circle and patterns of overlapping circles) and quantitative characteristics (including geometric measurements of circle areas and distances between centroids). We additionally conducted exploratory drawing analyses to evaluate whether subjects completed the task according to the provided instructions, and to examine the left-right spatial arrangement of the circles. Group comparisons of the qualitative and quantitative Circle Test measures and correlations between these measures and MMSE-J scores within each subject group were evaluated using Bayes factors.
Results：No group differences in Circle Test indices were identified between the three groups. In the AD and MCI groups, the past-future centroid distance correlated positively with the MMSE-J serial 7 scores；however, in the non-MCI group, the past-present centroid distance showed a negative correlation. In total, 19 subjects (15 with AD and 4 with MCI) were unable to complete the Circle Test according to the provided instructions.
Conclusion：Overall, these findings suggest that future-related aspects of time perspective in patients with AD and MCI may be associated with attentional function. They further indicate the potential usefulness of the Circle Test for assessing time perspective in patients with neurodegenerative diseases, although further validation is required.
