Disorientation to time is often first recognized in the doctor's office, where it is tested by asking the person the day, date and approximate hour. Often the person with dementia, to the surprise of their caregivers, cannot give this information. The family has not recognized it, because there is little need for such direct questioning.
Later in the disease, disorientation to time usually becomes more marked. It gives rise to a common problem later in the disease, in which the spouse with dementia wakens their sleeping partner at 3:00 am, all dressed up and ready to go out. This can be an exhausting ritual, although it often settles after a few weeks.