Abstract
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.
Highlights
Alzheimer’s disease (AD) is the most common form of dementia[1] and the cost estimates have improved, which reflects on economic burnout, with cost of approximately $818 billion[2]
There were no significant differences among the groups in terms of body mass index (BMI) and medication
Our results showed similar cognitive impairment in older adults living in long-term social and nursing care facilities (LTCF) and patients with AD, suggesting that elderly individuals in LTCF have a high risk of dementia, few screening psychiatric evaluations are implemented, leading to underdiagnosis in this population
Summary
Alzheimer’s disease (AD) is the most common form of dementia[1] and the cost estimates have improved, which reflects on economic burnout, with cost of approximately $818 billion[2]. Functional dependency and cognitive decline are the major causes of institutionalization as a result of residence long-term social and nursing care facilities (LTCF)[3]. Recent studies suggested that who have become institutionalized present more cognitive decline than those who remain in the community[4,5,6]. Institutionalization leads to a reduction in the motor demands inherent in social life and shows an important relationship with the decrease in cognitive abilities[7]. The physical activities undertaken in LTCF, in general, do not provide the appropriate intensity to improve the adaptative responses in the elderly[5]. Sedentary behaviour is associated with a decline in executive functions, a cognitive domain that is related to spatial navigation[8,9]
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