Spatial navigation performance differentiates Alzheimer´s disease biomarker positive and biomarker negative cognitively impaired older adults

Abstract

AbstractBackgroundSpatial navigation deficits including egocentric (body‐centered) and allocentric (world‐centered) navigation impairment are present early in Alzheimer´s disease (AD). We evaluated a potential of a realistic‐looking spatial navigation task to differentiate older adults with amnestic mild cognitive impairment (aMCI) who have positive AD biomarkers (AD aMCI) from those with negative AD biomarkers (non‐AD aMCI).MethodParticipants with AD aMCI (n = 24), non‐AD aMCI (n = 25), mild AD dementia (n = 14) and cognitively normal (CN) older adults (n = 35) underwent spatial navigation assessment in the virtual Supermarket task. Participants passively travelled through the supermarket and followed different routes to reach specific locations. In the final location, the participants had to indicate their starting location (egocentric heading) and their current location and final heading orientation on an aerial spatial map of the supermarket (distance from the correct location and allocentric heading, respectively, both measures of allocentric navigation).ResultIn the egocentric heading, the AD aMCI and mild AD dementia groups indicated their original starting location less accurately than the CN group (p<0.001) and with similar accuracy as the non‐AD aMCI group (p> = 0.219). The non‐AD aMCI group did not significantly differ from the CN group (p = 0.055). In the first allocentric task (distance from the correct location), the AD aMCI group and mild AD dementia groups indicated their positions on a paper aerial map of the supermarket with greater distance errors compared to the non‐AD aMCI group (p< = 0.013) and CN (p<0.001) groups. The non‐AD aMCI group had comparable performance to the CN group (p = 0.172). In the second allocentric task (allocentric heading), both the AD aMCI and mild AD dementia groups made more errors indicating final heading orientation than the non‐AD aMCI (p< = 0.040) and the CN (p<0.001) groups. The non‐AD aMCI group had worse performance than the CN group (p = 0.004). The sensitivity and specificity for discriminating AD aMCI and non‐AD aMCI was 72% and 71%, respectively.ConclusionBoth, egocentric and allocentric spatial navigation tasks detected spatial navigation impairment in older adults with AD aMCI. However, only the allocentric tasks differentiated AD aMCI from non‐AD aMCI. The virtual Supermarket task has a potential to become a screening tool for early AD‐related spatial navigation deficits.