Premium
Spatial navigation ability predicts progression of dementia symptomatology
Author(s) -
Levine Taylor F.,
Allison Samantha L.,
Stojanovic Marta,
Fagan Anne M.,
Morris John C.,
Head Denise
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.12031
Subject(s) - episodic memory , clinical dementia rating , dementia , psychology , hippocampus , alzheimer's disease , medicine , cognitive decline , cognition , disease , neuroscience
Abstract Introduction Spatial navigation deficits are observed in Alzheimer's disease cross‐sectionally, but prediction of longitudinal clinical decline has been less examined. Methods Cognitive mapping (CM) was assessed in 95 participants and route learning (RL) was assessed in 65 participants at baseline. Clinical progression over an average of 4 to 5 years was assessed using the clinical dementia rating (CDR) scale. Relative predictive ability was compared to episodic memory, hippocampus, and cerebrospinal fluid biomarkers (phosphorylated tau/amyloid β 42 (ptau 181 /Aβ 42 ) ratio). Results CM and RL were predictors of clinical progression ( P ’s < 0.032). All measures, except RL‐Learning remained predictors with episodic memory in models ( P ’s < 0.048). Only RL‐Retrieval remained a predictor when ptau 181 /Aβ 42 was included ( P < 0.001). CM interacted with hippocampus and ptau 181 /Aβ 42 in prediction ( P ’s < 0.013). CM, RL, and episodic memory evidenced strong diagnostic accuracy (area under the curve (AUC) = 0.894, 0.794, and 0.735, respectively); CM tended to perform better than episodic memory ( P = 0.056). Discussion Baseline spatial navigation performance may be appropriate for assessing risk of clinical progression.