Floor Maze Test as a predictor of cognitive decline in older adults living in nursing homes

Abstract

Objective Long-term care facilities (LTCF) are associated with an increased risk of cognitive decline and impairment in spatial navigation abilities. Recent studies have demonstrated that spatial navigation as a complex skill, involving cognitive and motor functions, emerging as a new marker for the progression of dementia. The present study aims to compare spatial navigation in healthy, institutionalized, and AD elderly subjects. Methods In a cross-sectional study, we evaluated 78 elderly individuals (healthy = 37, AD = 22, institutionalized = 19) using the Mini-Mental State Examination (MMSE), Floor Maze Test (FMT) and 8-foot-up-and-gotest (8UG) to assess global cognitive function, spatial navigation and motor function, respectively. Results In the FMT, the immediate maze time (IMT) and delay maze time (DMT) were significantly shorter in the healthy group than those of the institutionalized and AD groups ( X 2 = 31.23; p < 0.01) and ( X 2 = 41.21; p < 0.01), while there were no significant differences between the AD and institutionalized groups in terms of the DMT and MMSE results. However, the institutionalized group showed worse results in terms of IMT (p < 0.01) and 8UG (p < 0.01) than those in the dementia group. Conclusion Our results indicate that both institutionalized older people and patients with Dementia have a deficit in the spatial navigation ability, cognitive functions and motor skills. We should consider that there might be a possibility of underdiagnosis in institutionalized older people.

Floor Maze Test is capable of differentiating spatial navigation between frail and pre-frail institutionalized older persons

“…Both spatial navigation and frailty seem to be dementia predictors 12,21 . Our results demonstrate that the FMT, in addition to being a predictor of MCI, motor deficit, and a predictor of prodromal dementia 9,16,17 , is a practical test, of easy clinical application and low cost, 21 that can be used to differentiate from pre-frail and frail older adults through spatial navigation. It facilitates the diagnosis of cognitive decline and frailty, which are two important conditions related to the health of institutionalized older adults.…”

“…Some studies report an association between spatial navigation, global cognition, and cognitive impairment 16 , 17 . Tangen et al 17 verified that individuals with subjective cognitive impairment, MCI, and AD had worse performance in the FMT, according to the severity of the impairment.…”

“…The Floor Maze Test is an instrument for measuring spatial navigation ability, executive functions, and memory, which has been applied to institutionalized older adults for cognitive screening 16 , 21 . Among the reasons for choosing this instrument are its ease of application, low cost, and reliability of results 21 .…”

“…Among the cognitive domains affected in institutionalized older adults is the spatial navigation ability 16 , which is characterized by the integration of complex cognitive processes, such as visual perception, learning, memory, and executive functions [16][17][18] . The hippocampus, parahippocampal gyrus, prefrontal, parietal and entorhinal cortex are the main brain regions triggered by spatial navigation ability and are sensitive to normal aging 19,20 .…”

2D Virtual Reality-Based Exercise Improves Spatial Navigation in Institutionalized Non-robust Older Persons: A Preliminary Data Report of a Single-Blind, Randomized, and Controlled Study

“…Spatial navigation is considered among the scientific community as a strong predictor of both cognitive impairment and Alzheimer's disease ( 6 , 17 , 18 ). Immediate FMT performance time is associated with executive functions and involves, mainly, planning, mental flexibility, and processing speed ( 14 ), functions which might be harmed in dementia cases and are paramount to maintaining independence and postponing institutionalization ( 4 , 17 , 19 ).…”