Spatial Navigation Complaints are Associated with Anxiety Regardless of the Real Performance in Non-Demented Elderly

Abstract

Objective: Memory complaints in non-demented elderly are reported frequently and are often associated with depression/anxiety. The relationship between depression/anxiety, memory complaints and risk of dementia is unclear. Spatial disorientation is a common problem reported by patients with early Alzheimer´s disease (AD). Objective testing of spatial navigation (SN) in human analogue of Morris water maze showed that subject with mild cognitive impairment (MCI) present with identical SN impairment as AD patients. There is not much known about how subjective perception of spatial navigation skills reflects the real SN performance and whether depression/anxiety plays a role in this association. We investigated whether subjects with MCI reported more subjective spatial navigation complaints (SSNC) than individuals with subjective cognitive decline (SCD) with no cognitive deficit and whether SSNC reporting depends on anxiety or/and depression regardless of real SN performance. Methods: A total of 123 non-demented participants, including 52 with SCD and 71 with MCI underwent spatial navigation (SN) testing, neuropsychological examination and completed SSNC questionnaire, Geriatric Depression Scale (GDS), and Beck Anxiety Inventory (BAI). Results: There were no differences in GDS and BAI scores between MCI and SMC groups. The MCI group did not report more SSNC than SMC group regardless of worse real-SN performance in the MCI group (p<0.001). Anxiety explained most of the SSNC (p<0.001). A median split by BAI (≤ 10) and GDS (≤ 4) scores were used to classify participants into 4 groups- normal (n=44), anxious (n=18), depressive (n=13) and anxious/depressive (n=34). The anxious/depressive and anxious groups reported more SSNC than normal (p=0.006; p=0.036) and depressive groups (p=0.018; p=0.031). Conclusion: General complaints about SN performance do not rely on actual cognitive status. Anxiety rather than depression influences subjective perception of SN abilities in non-demented elderly, regardless of their objective SN deficit. Screening for anxiety, rather than only for depression, may be useful to evaluate subjective complaints.