{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:18:02Z","timestamp":1788877082315,"version":"build-2803163510"},"reference-count":14,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Italian Ministry of Health - Ricerca Corrente","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In clinical settings, the head turning sign (HTS) occurs when patients with cognitive complaints turn their head toward the accompanying person seeking assistance. Due to its nature, and unlike other non-canonical neurological signs of cognitive impairment, the HTS is likely to occur in ecological, daily-life scenarios too. However, this hypothesis has not been tested yet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the prevalence and clinical correlates of the \u201cecological HTS\u201d (eHTS) in MCI and dementia due to chronic-degenerative etiologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort included 112 patients with MCI\/dementia due to Alzheimer's disease (AD;\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u200971), frontotemporal lobar degeneration (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u20096), Lewy body disease (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u20096), chronic cerebrovascular diseases (CVD;\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u200911), mixed (i.e., AD\u2009+\u2009CVD;\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u200915) unspecified non-AD neurodegenerative etiologies (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u20093). We recorded the number of HTSs displayed by patients during the MMSE and inquired accompanying persons whether the HTS occurred in daily life too.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall prevalence of the eHTS in the cohort was 50%; its distribution was independent of demographics, disease severity (i.e., MCI versus dementia), and etiology. Within multiple logistic models, the presence of the eHTS\u2009+\u2009proved to be predicted both by lower scores on the\n                      <jats:italic toggle=\"yes\">Spatial Orientation<\/jats:italic>\n                      subtest of the MMSE and by a higher number of HTSs during the execution of the MMSE. Moreover, a trend towards longer disease duration and the occurrence of the eHTS was found.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In MCI and dementia, the HTS is an ecologically valid non-canonical sign, frequently occurs in daily life too, associated with longer disease duration and spatial disorientation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261452271","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T08:45:12Z","timestamp":1779698712000},"page":"659-666","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The head turning sign \u201coutside the clinic walls\u201d in patients with mild cognitive impairment and dementia"],"prefix":"10.1177","volume":"112","author":[{"given":"Edoardo Nicol\u00f2","family":"Aiello","sequence":"first","affiliation":[{"name":"IRCCS Istituto Auxologico Italiano"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cazzini","sequence":"additional","affiliation":[{"name":"University of Padua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Moreschi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Auxologico Italiano"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Curti","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Auxologico Italiano"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"De Luca","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Auxologico Italiano"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Frisco","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Auxologico 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