Abstract
The Virtual Supermarket Task (VST) and Sea Hero Quest detect high-genetic-risk Alzheimer`s disease (AD). We aimed to determine their test-retest reliability in a preclinical AD population. Over two time points, separated by an 18-month period, 59 cognitively healthy individuals underwent a neuropsychological and spatial navigation assessment. At baseline, participants were classified as low-genetic-risk of AD or high-genetic-risk of AD. We calculated two-way mixed effects intraclass correlation coefficients (ICC) for task parameters and used repeated measures ANOVAS to determine whether genetic risk or sex contributed to test-retest variability. The egocentric parameter of the VST measure showed the highest test–retest reliability (ICC = .72), followed by the SHQ distance travelled parameter (ICC = .50). Post hoc longitudinal analysis showed that boundary-based navigation predicts worsening episodic memory concerns in high-risk (F = 5.01, P = 0.03), but in not low-risk, AD candidates. The VST and the Sea Hero Quest produced parameters with acceptable test-retest reliability. Further research in larger sample sizes is desirable.
Highlights
Spatial navigation shows promise as an outcome measure for preclinical Alzheimer disease (AD) in drug treatment trials, but it’s test-retest reliability is not clear [1,2,3,4]
Having previously determined the diagnostic utility of Virtual Supermarket Task (VST) and Sea Hero Quest (SHQ) in at-genetic-risk Alzheimer‘s disease (AD), we aimed to establish the test-retest reliability of these two spatial navigation tasks
There was no significant change in global cognitive performance (Δ) between genetic groups from baseline to retest, except on Addenbrooke’s Cognitive Examination—III (ACE) memory sub-scale (t = 2.41, p = 0.02), with ε4 carriers’ performance improving significantly more over the 18-month study period compared to ε3 carriers
Summary
Spatial navigation shows promise as an outcome measure for preclinical Alzheimer disease (AD) in drug treatment trials, but it’s test-retest reliability is not clear [1,2,3,4]. Drug development for AD has been plagued by the failure of cognitive outcomes measures to detect treatment response due to i) insufficient sensitivity and specificity for preclinical neuropathology and/or ii) poor test-retest reliability, both of which can mask neural response to treatment [5,6,7,8]. The Virtual Supermarket Task (VST) and Sea Hero Quest (SHQ) identify cognitive changes due to functional neural abnormalities within the spatial navigation network ( the entorhinal cortex and hippocampus) in at-geneticrisk AD, making them sensitive and specific measures for preclinical AD disease [2, 9,10,11]. Spatial navigation studies have overlooked the need to establish the testretest reliability of these measures in preclinical AD populations, opting to focus on cross-sectional group comparisons or self-report scales [12], with one exception [13].
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