Spatial Navigation and Visuospatial Strategies in Typical and Atypical Aging

Age-related spatial navigation decline is more pronounced in patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) dementia. We used a realistic-looking virtual navigation test suite to analyze different aspects of visuospatial processing in typical and atypical aging. A total of 219 older adults were recruited from the Czech Brain Aging Study cohort. Cognitively normal older adults (CN; n = 78), patients with amnestic MCI (n = 75), and those with mild AD dementia (n = 66) underwent three navigational tasks, cognitive assessment, and brain MRI. Route learning and wayfinding/perspective-taking tasks distinguished the groups as performance and learning declined and specific visuospatial strategies were less utilized with increasing cognitive impairment. Increased perspective shift and utilization of non-specific strategies were associated with worse task performance across the groups. Primacy and recency effects were observed across the groups in the route learning and the wayfinding/perspective-taking task, respectively. In addition, a primacy effect was present in the wayfinding/perspective-taking task in the CN older adults. More effective spatial navigation was associated with better memory and executive functions. The results demonstrate that a realistic and ecologically valid spatial navigation test suite can reveal different aspects of visuospatial processing in typical and atypical aging.

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Functional Capacity, Cognition And Spatial Navigation In Older Adults With Mild Cognitive Impairment

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000560820.62989.b8 ◽

2019 ◽

Vol 51 (Supplement) ◽

pp. 108

Author(s):

Jessica Plácido ◽

José Vinicius Ferreira ◽

Felipe Oliveira ◽

Paula Santana ◽

Renato Sobral Monteiro-Junior ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Functional Capacity ◽

Spatial Navigation

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P050 Familiar locations and new locations: sleep’s role in the consolidation of spatial navigation information using a novel virtual Morris water maze task in older adults with mild cognitive impairment

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.097 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A37-A37

Author(s):

C Haroutonian ◽

I Johnston ◽

A Ricciardiello ◽

A Lam ◽

R Grunstein ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Repeated Measures ◽

Spatial Navigation ◽

Memory Retention ◽

Functional Impairments ◽

Morris Water Maze Task ◽

Before And After ◽

Start Location

Abstract Introduction The ability to navigate oneself in space is one of the first functional impairments in Alzheimer’s disease (AD). A 3D-computerised spatial navigation (SN) task was designed to delineate, for the first time in a sleep-dependent memory paradigm, egocentric and allocentric SN, the latter identified as one cognitive biomarker of AD. We examined group differences in SN memory and associations with sleep macroarchitecture. Methods Older adults with mild cognitive impairment (MCI, n=32) and controls (n=25) underwent overnight polysomnography and completed the SN task before and after sleep. Participants learnt the location of a target over 5 trials (familiar location; egocentric-dependent), then were instructed to find the target from a novel start location (allocentric-dependent). Memory % retention (MR) from both start locations were calculated by the XY coordinate of marked location to correct location of the target, pre- and post-sleep. Navigational strategies were coded using self-reported description of how participants’ found the target. Associations between MR with REM and SWS % duration, and AHI in REM and NREM were examined using Spearman’s correlations. Results Repeated-measures ANOVA showed Controls MR improved overnight whereas MCI performed worse (F=7.46, p=.009), with greatest differences on familiar start location MR (p=.02). Strategy as a covariate revealed a location by strategy interaction (p=01). Novel location MR was associated with REM%, rho=.448, (p=.02) in Controls, and REM-AHI, rho=.400 (p=.02) in MCI. Conclusion Behavioural and self-reported results suggest disrupted SN strategies relative to environment in MCI. Future studies should examine SN in association with sleep-wake neurophysiology and neuronal integrity.

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Cognitive Impairment Trends Among Older Adults in a Medicaid Home and Community-Based Service Program

Innovation in Aging ◽

10.1093/geroni/igab046.060 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 17-17

Author(s):

Richard Fortinsky ◽

Julie Robison ◽

David Steffens ◽

James Grady ◽

Deborah Migneault

Keyword(s):

High School ◽

Older Adults ◽

Cognitive Impairment ◽

Ethnic Group ◽

Race And Ethnicity ◽

Group Identification ◽

School Education ◽

High School Education ◽

Nursing Home Admission ◽

Study Cohort

Abstract Cognitive impairment (CI) is an important risk factor for nursing home admission, but little is known about CI among older adults in Medicaid HCBS programs. Racial and ethnic group CI disparities are found among community-dwelling older adults, but these CI trends have not been explored in Medicaid HCBS populations. In this study, we determined how CI is associated with older adults’ racial and ethnic group identification and educational attainment in Connecticut’s Medicaid HCBS program. The study cohort includes program enrollees age >65 during January-March 2019 (N=3,520). CI measures include: Cognitive Performance Scale (CPS), ranging from 0-8 (cognitively intact to very severe impairment); and a dichotomous measure incorporating Alzheimer’s disease or other dementia diagnosis (ADRD) and CPS score signifying moderate or severe CI. Study cohort characteristics: 75.7% female; age, mean(sd)=79.1(8.2); Non-Hispanic White=47.8%; Non-Hispanic Black=15.9%; Non-Hispanic Other=2.7%; Hispanic=33.6%; HS education=21.7%; mean(sd) CPS score=2.7(1.9); 36.1% with ADRD/high CPS2 score. In multivariate regression models adjusting for age and sex, CPS scores were not independently associated with race and ethnicity, and the likelihood of having ADRD/high CPS scores did not differ by race and ethnicity (all p-values >0.05). In these same models, persons with more than high school education had significantly lower CPS scores (b=-.12; p<.001), and significantly lower likelihood of having ADRD/high CPS scores (AOR=0.61; p<.001), than persons with less than high school education. We conclude that educational level is independently associated with CI, but race and ethnicity are not in this cohort. Policy and practice implications will be discussed.

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The virtual cognitive health (VC Health) study: design, recruitment, and baseline characteristics of a fully remote single-arm pre-post study to prevent or delay cognitive impairment in older adults (Preprint)

10.2196/preprints.11368 ◽

2018 ◽

Author(s):

Nick Bott ◽

Shefali Kumar ◽

Caitlyn Krebs ◽

Jordan M Glenn ◽

Erica N Madero ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Study Design ◽

Health Study ◽

Study Cohort ◽

Lifestyle Interventions ◽

Subjective Memory ◽

Memory Decline ◽

Cognitive Health ◽

The Impact

BACKGROUND A growing body of evidence supports the use of lifestyle interventions for preventing or delaying the onset of Alzheimer’s disease (AD) and other forms of dementia in at-risk individuals. The development of virtually delivered programs would increase the scalability and reach of these interventions, but requires validation to ensure similar efficacy to brick and mortar options. OBJECTIVE The aims of this study are to describe the study design, recruitment process, and baseline participant characteristics of the sample in the virtual cognitive health (VC Health) study. Future analyses will assess the impact of the remotely delivered lifestyle intervention on (1) cognitive function, (2) depression and anxiety, and (3) various lifestyle behaviors, including diet, exercise, and sleep in a cohort of older adults with subjective memory decline. Additional analyses will explore feasibility outcomes, as well as the participants’ engagement patterns with the program. METHODS Older adults (age 60-75) with subjective memory decline as measured by the Subjective Cognitive Decline (SCD-9) questionnaire, and who reported feeling worried about their memory decline, were eligible to participate in this single-arm pre-post study. All participants enrolled in the year-long virtual intervention, which consists of health coach-guided lifestyle change for improving diet, exercise, sleep, stress, and cognition. All components of this study were conducted virtually, including the collection of data and the administration of the intervention. Participants were assessed at baseline, 12 weeks, 24 weeks, and 52 weeks with online surveys and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) test. Intention-to-treat analysis will be conducted on all outcomes. RESULTS A total of 85 participants enrolled in the intervention and 82 are included in the study sample (3 participants withdrew). The study cohort is 74% female, 88% Caucasian, 78% overweight or obese, and 67% have at least a college degree. The average baseline RBANS score was 95.9±11.1, which is within age-adjusted norms. The average SCD-9 score was 6.0±2.0, indicating minor subjective cognitive impairment at the beginning of the study. Average baseline Generalized Anxiety Disorder (GAD-7) scores were 6.2±4.5 and Patient Health Questionnaire (PHQ-9) scores were 8.5±4.9, indicating mild levels of anxiety and depression at baseline. CONCLUSIONS Virtually delivered lifestyle interventions may represent a scalable solution for the prevention or delay of AD. The results of this study will provide the first evidence for the efficacy of a fully remote intervention and lay the groundwork for future investigations. CLINICALTRIAL NCT02969460

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Beyond the Mini-Mental State Examination: The Use of Physical and Spatial Navigation Tests to Help to Screen for Mild Cognitive Impairment and Alzheimer’s Disease

Journal of Alzheimer s Disease ◽

10.3233/jad-210106 ◽

2021 ◽

pp. 1-10

Author(s):

Jessica Plácido ◽

José Vinicius Ferreira ◽

Juliana Araújo ◽

Felipe de Oliveira Silva ◽

Renan Baltar Ferreira ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Mental State ◽

Mini Mental State Examination ◽

Spatial Navigation ◽

Motor Test ◽

State Examination

Background: Spatial navigation and dual-task (DT) performance may represent a low-cost approach to the identification of the cognitive decline in older adults and may support the clinical diagnosis of mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Objective: To assess the accuracy of different types of motor tasks in differentiating older persons with MCI and AD from healthy peers. Methods: Older adults aged 60 years or over (n = 105; healthy = 39; MCI = 23; AD = 43) were evaluated by the floor maze test (FMT), the senior fitness test, and DT performance. Receiver operating characteristic curve (ROC) analysis was used to evaluate the accuracy of the tests. We also performed principal component analysis (PCA) and logistic regression analysis to explore the variance and possible associations of the variables within the sample. Results: FMT (AUC = 0.84, sensitivity = 75.7%, specificity = 76.1%, p < 0.001) and DT (AUC = 0.87, sensitivity = 80.4%, specificity = 86.9%, p < 0.001) showed the highest performance for distinguishing MCI from AD individuals. Moreover, FMT presented better sensitivity in distinguishing AD patients from their healthy peers (AUC = 0.93, sensitivity = 94%, specificity = 85.6%, p < 0.001) when compared to the Mini-Mental State Examination. PCA revealed that the motor test performance explains a total of 73.9% of the variance of the sample. Additionally, the results of the motor tests were not influenced by age and education. Conclusion: Spatial navigation tests showed better accuracy than usual cognitive screening tests in distinguishing patients with neurocognitive disorders.

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The Combined Effect of APOE and BDNF Val66Met Polymorphisms on Spatial Navigation in Older Adults

Journal of Alzheimer s Disease ◽

10.3233/jad-200615 ◽

2020 ◽

Vol 78 (4) ◽

pp. 1473-1492

Author(s):

Jan Laczó ◽

Katerina Cechova ◽

Martina Parizkova ◽

Ondrej Lerch ◽

Ross Andel ◽

...

Keyword(s):

Older Adults ◽

Verbal Memory ◽

Medial Temporal Lobe ◽

Brain Aging ◽

Spatial Navigation ◽

Memory Performance ◽

Brain Mri ◽

Brain Regions ◽

Real Space ◽

Egocentric Navigation

Background: The apolipoprotein E (APOE) ɛ4 allele is associated with episodic memory and spatial navigation deficits. The brain-derived neurotrophic factor (BDNF) Met allele may further worsen memory impairment in APOE ɛ4 carriers but its role in APOE ɛ4-related spatial navigation deficits has not been established. Objective: We examined influence of APOE and BDNF Val66Met polymorphism combination on spatial navigation and volumes of selected navigation-related brain regions in cognitively unimpaired (CU) older adults and those with amnestic mild cognitive impairment (aMCI). Methods: 187 participants (aMCI [n = 116] and CU [n = 71]) from the Czech Brain Aging Study were stratified based on APOE and BDNF Val66Met polymorphisms into four groups: ɛ4–/BDNFVal/Val, ɛ4–/BDNFMet, ɛ4+/BDNFVal/Val, and ɛ4+/BDNFMet. The participants underwent comprehensive neuropsychological examination, brain MRI, and spatial navigation testing of egocentric, allocentric, and allocentric delayed navigation in a real-space human analogue of the Morris water maze. Results: Among the aMCI participants, the ɛ4+/BDNFMet group had the least accurate egocentric navigation performance (p < 0.05) and lower verbal memory performance than the ɛ4–/BDNFVal/Val group (p = 0.007). The ɛ4+/BDNFMet group had smaller hippocampal and entorhinal cortical volumes than the ɛ4–/BDNFVal/Val (p≤0.019) and ɛ4–/BDNFMet (p≤0.020) groups. Among the CU participants, the ɛ4+/BDNFMet group had less accurate allocentric and allocentric delayed navigation performance than the ɛ4–/BDNFVal/Val group (p < 0.05). Conclusion: The combination of APOE ɛ4 and BDNF Met polymorphisms is associated with more pronounced egocentric navigation impairment and atrophy of the medial temporal lobe regions in individuals with aMCI and less accurate allocentric navigation in CU older adults.

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Toward Identifying Mild Cognitive Impairment in Hispanic and African American Adults

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp2.sig2.110 ◽

2017 ◽

Vol 2 (2) ◽

pp. 110-116

Author(s):

Valarie B. Fleming ◽

Joyce L. Harris

Keyword(s):

Older Adults ◽

African American ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Healthcare Access ◽

Communication Disorders ◽

Healthcare Systems ◽

Prevention Education ◽

Education Management ◽

African American Adults

Across the breadth of acquired neurogenic communication disorders, mild cognitive impairment (MCI) may go undetected, underreported, and untreated. In addition to stigma and distrust of healthcare systems, other barriers contribute to decreased identification, healthcare access, and service utilization for Hispanic and African American adults with MCI. Speech-language pathologists (SLPs) have significant roles in prevention, education, management, and support of older adults, the population must susceptible to MCI.

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