Spatial navigation and risk of cognitive impairment: A prospective cohort study

Abstract

INTRODUCTION Spatial navigation deficits are reported in dementia, but their temporal relationship to cognitive decline is not established. METHODS Prospective cohort study in 442 non-demented adults (mean age 79.9 years). Spatial navigation measured with the Floor Maze Test, and reported as immediate maze time (IMT) and delayed maze time (DMT). Pre-dementia syndromes, Mild Cognitive Impairment (MCI) and Motoric Cognitive Risk (MCR) syndromes, were primary outcomes. RESULTS Over a mean follow-up of 16.5 ± 13.7 months, 41 participants developed MCI and 30 MCR. In Cox models adjusted for age, sex, education, cognitive status, comorbid illnesses, and maze errors, a 10-second increment on IMT predicted incident MCI (adjusted hazard ratio [aHR] 1.25; 95% CI 1.06 to 1.48) and MCR (aHR 1.53; 95% CI 1.23 to 1.90). DMT predicted MCR but not MCI. DISCUSSION Spatial navigation performance predicted pre-dementia syndromes in aging, and implicates navigational impairments as an early feature in dementias.

Spatial navigation ability predicts progression of dementia symptomatology

“…Overall, current findings are consistent with two prior investigations examining the ability of spatial navigation tasks to predict conversion to MCI, and conversion from MCI to symptomatic AD (but see reference ). Of note, these studies utilized mainly CM tasks for assessing spatial navigation and did not incorporate comparisons to AD biomarkers or episodic memory.…”

“…23 Differential utility of CM measures is also consistent with neuropathology occurring early in CM-relevant brain regions, such as entorhinal cortex and hippocampus. 7,[17][18][19] Overall, current findings are consistent with two prior investigations examining the ability of spatial navigation tasks to predict conversion to MCI, and conversion from MCI to symptomatic AD 48,49 (but see reference 50 ). Of note, these studies utilized mainly CM tasks for assessing spatial navigation and did not incorporate comparisons to AD biomarkers or episodic memory.…”

Spatial Disorientation in Alzheimer's Disease: The Missing Path From Virtual Reality to Real World

“…Practically, it can be challenging for elderly AD patients to perform VR tasks on the computer and VR-induced motion sickness remains a relevant concern in this population (Bohil et al, 2011;Verghese et al, 2017). Similarly, VR navigation may not capture the vividness of RW settings since they often lack auditory/olfactory cues or locomotion, a crucial feature of RW navigation (van der Ham et al, 2015;O'Malley et al, 2017; although see Howett et al, 2019 for a VR paradigm incorporating RW walking).…”

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

“…Better performance in the FMT has been associated with lower risk of cognitive decline and may be useful for assessing cognitive abilities, considering the low cost, ease of application and ecological characteristics [10][11][12] . Recently, Verghese et al verified, that every 10 seconds in the FMT score is related to 25% increase in the risk of dementia 15 .…”