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Spatial navigation measured by the Floor Maze Test in patients with subjective cognitive impairment, mild cognitive impairment, and mild Alzheimer's disease

Published online by Cambridge University Press:  03 February 2015

Gro Gujord Tangen ,
Knut Engedal ,
Astrid Bergland ,
Tron Anders Moger ,
Oskar Hansson  and
Anne Marit Mengshoel
Gro Gujord Tangen*
Affiliation:
Department of Health Sciences, University of Oslo, Norway
Knut Engedal
Affiliation:
Norwegian Centre for Ageing and Health, Vestfold Health Trust, Tønsberg, Norway
Astrid Bergland
Affiliation:
Oslo and Akershus University College of Applied Sciences, Oslo, Norway
Tron Anders Moger
Affiliation:
Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
Oskar Hansson
Affiliation:
Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden Memory Clinic, Skåne University Hospital, Lund and Malmö, Sweden
Anne Marit Mengshoel
Affiliation:
Department of Health Sciences, University of Oslo, Norway
*
Correspondence should be addressed to: Gro Gujord Tangen, Department of Health Sciences, University of Oslo, P.O. Box 1089 Blindern, 0317 Oslo, Norway. Phone: +00 47 22 84 53 71; Fax: +00 47 22 84 50 91. Email: g.g.tangen@medisin.uio.no.
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Abstract

Background:

Impaired spatial navigation is an early sign of Alzheimer's disease (AD), but this can be difficult to assess in clinical practice. We examined how the performance on the Floor Maze Test (FMT), which combines navigation with walking, differed between patients with subjective cognitive impairment (SCI), mild cognitive impairment (MCI), and mild AD. We also explored if there was a significant relationship between the FMT and the cognitive tests or sociodemographic factors.

Methods:

The study included 128 patients from a memory clinic classified as having SCI (n = 19), MCI (n = 20), and mild AD (n = 89). Spatial navigation was assessed by having the patients walk through the FMT, a two-dimensional maze. Both timed measures and number of errors were recorded. Cognitive function was assessed by the Word List Memory test, the Clock Drawing test, the Trail Making tests (TMT) A and B, and the Mini Mental Status Examination (MMSE).

Results:

The patients with MCI were slower than those with SCI, while the patients with mild AD more frequently completed the FMT with errors or gave up than the patients with MCI. Performance on the FMT was significantly associated with executive function (measured by TMT-B).

Conclusions:

The performances on the FMT worsened with increasing severity of cognitive impairment, and the FMT was primarily associated with executive function. The explained variance was relatively low, which may indicate that the standard cognitive test battery does not capture impairments of spatial navigation.

Keywords

spatial navigationcognitionAlzheimermild cognitive impairmentsubjective cognitive impairment
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 8 , August 2015 , pp. 1401 - 1409
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

Benke, T., Karner, E., Petermichl, S., Prantner, V. and Kemmler, G. (2013). Neuropsychological deficits associated with route learning in Alzheimer disease, MCI, and normal aging. Alzheimer Disease and Associated Disorders, 2, 162–167. doi: 10.1097/WAD.0000000000000009.Google Scholar
Braak, H. and Braak, E. (1991). Neuropathological stageing of Alzheimer-related changes. Acta Neuropathologica, 82, 239–259.CrossRefGoogle ScholarPubMed
Burns, P. C. (1999). Navigation and the mobility of older drivers. The journals of geronotology. Series B, Psychological sciences and social sciences, 54, S49–S55.CrossRefGoogle ScholarPubMed
Chiu, Y. C., Algase, D., Liang, J., Liu, H. C. and Lin, K. N. (2005). Conceptualization and measurement of getting lost behavior in persons with early dementia. International Journal of Geriatric Psychiatry, 20, 760–768. doi: 10.1002/gps.1356.CrossRefGoogle ScholarPubMed
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.CrossRefGoogle ScholarPubMed
Cushman, L. A., Stein, K. and Duffy, C. J. (2008). Detecting navigational deficits in cognitive aging and Alzheimer disease using virtual reality. Neurology, 71, 888–895. doi: 10.1212/01.wnl.0000326262.67613.fe.CrossRefGoogle ScholarPubMed
deIpolyi, A. R., Rankin, K. P., Mucke, L., Miller, B. L. and Gorno-Tempini, M. L. (2007). Spatial cognition and the human navigation network in AD and MCI. Neurology, 69, 986–997. doi: 10.1212/01.wnl.0000271376.19515.c6.CrossRefGoogle ScholarPubMed
Fillenbaum, G. G.et al. (2008). Consortium to establish a registry for Alzheimer's disease (CERAD): the first twenty years. Alzheimer's & Dementia, 4, 96–109. doi: 10.1016/j.jalz.2007.08.005.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Gallistel, C. R. (1990). The Organization of Learning. Cambridge, MA: MIT Press.Google Scholar
Hesseberg, K., Bentzen, H., Ranhoff, A.H., Engedal, K. and Bergland, A. (2013). Disability in instrumental activities of daily living in elderly patients with mild cognitive impairment and Alzheimer's disease. Dementia and Geriatric Cognitive Disorders; 36, 146–153. doi: 10.1159/000351010.CrossRefGoogle ScholarPubMed
Hort, J., Laczo, J., Vyhnalek, M., Bojar, M., Bures, J. and Vlcek, K. (2007). Spatial navigation deficit in amnestic mild cognitive impairment. Proceedings of the National Academy of Sciences USA, 104, 4042–4047. doi: 10.1073/pnas.0611314104.CrossRefGoogle ScholarPubMed
Jessen, F.et al. (2010). Prediction of dementia by subjective memory impairment: effects of severity and temporal association with cognitive impairment. Archives of General Psychiatry, 67, 414–422. doi: 10.1001/archgenpsychiatry.2010.30.CrossRefGoogle ScholarPubMed
Johnson, D. K., Storandt, M., Morris, J. C. and Galvin, J. E. (2009). Longitudinal study of the transition from healthy aging to Alzheimer disease. Archives of Neurology, 66, 1254–1259. doi: 10.1001/archneurol.2009.158.CrossRefGoogle ScholarPubMed
Kalova, E., Vlcek, K., Jarolimova, E. and Bures, J. (2005). Allothetic orientation and sequential ordering of places is impaired in early stages of Alzheimer's disease: corresponding results in real space tests and computer tests. Behavioural Brain Research, 159, 175–186. doi: 10.1016/j.bbr.2004.10.016.CrossRefGoogle ScholarPubMed
Laczo, J.et al. (2012). From Morris Water Maze to computer tests in the prediction of Alzheimer's disease. Neurodegenerative Diseases, 10, 153–157. doi: 10.1159/000333121.CrossRefGoogle ScholarPubMed
Lovden, M., Schellenbach, M., Grossman-Hutter, B., Kruger, A. and Lindenberger, U. (2005). Environmental topography and postural control demands shape aging-associated decrements in spatial navigation performance. Psychology and Aging, 20, 683–694. doi: 10.1037/0882-7974.20.4.683.CrossRefGoogle ScholarPubMed
Moffat, S. D. (2009). Aging and spatial navigation: what do we know and where do we go? Neuropsychology Review, 19, 478–489. doi: 10.1007/s11065-009-9120-3.CrossRefGoogle ScholarPubMed
O’Keefe, J. and Nadel, L. (1978). The Hippocampus as a Cognitive Map, Oxford: Oxford University Press.Google Scholar
Pai, M. C. and Jacobs, W. J. (2004). Topographical disorientation in community-residing patients with Alzheimer's disease. International Journal of Geriatric Psychiatry, 19, 250–255. doi: 10.1002/gps.1081.CrossRefGoogle ScholarPubMed
Passini, R., Rainville, C., Marchand, N. and Joanette, Y. (1995). Wayfinding in dementia of the Alzheimer type: planning abilities. Journal of Clinical and Experimental Neuropsychology, 17, 820–832. doi: 10.1080/01688639508402431.CrossRefGoogle ScholarPubMed
Reisberg, B., Shulman, M. B., Torossian, C., Leng, L. and Zhu, W. (2010). Outcome over seven years of healthy adults with and without subjective cognitive impairment. Alzheimer's & Dementia, 6, 11–24. doi: 10.1016/j.jalz.2009.10.002.CrossRefGoogle ScholarPubMed
Reisberg, B.et al. (2008). The pre-mild cognitive impairment, subjective cognitive impairment stage of Alzheimer's disease. Alzheimer's & Dementia, 4 (Suppl. 1), S98–S108. doi: 10.1016/j.jalz.2007.11.017.CrossRefGoogle ScholarPubMed
Reitan, R. M. (1955). The relation of the trail making test to organic brain damage. Journal of Consulting and Clinical Psychology, 19, 393–394.CrossRefGoogle ScholarPubMed
Sanders, A. E., Holtzer, R., Lipton, R. B., Hall, C. and Verghese, J. (2008). Egocentric and exocentric navigation skills in older adults. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciencesi, 63, 1356–1363.CrossRefGoogle ScholarPubMed
Shulman, K. I. (2000). Clock-drawing: is it the ideal cognitive screening test? International Journal of Geriatric Psychiatry, 15, 548–561. doi: 10.1002/1099-1166(200006)15:6<548::AID-GPS242>3.0.CO;2-U.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Taillade, M.et al. (2013). Age-related wayfinding differences in real large-scale environments: detrimental motor control effects during spatial learning are mediated by executive decline? PloS One, 8, e67193. doi: 10.1371/journal.pone.0067193.CrossRefGoogle ScholarPubMed
Tangen, G. G., Engedal, K., Bergland, A., Moger, T. A. and Mengshoel, A. M. (2014). Relationships between balance and cognition in patients with subjective cognitive impairment, mild cognitive impairment, and Alzheimer disease. Physical Therapy, 94, 1123–1134. doi: 10.2522/ptj.20130298.CrossRefGoogle ScholarPubMed
Winblad, B.et al. (2004). Mild cognitive impairment–beyond controversies, towards a consensus: report of the international working group on mild cognitive impairment. Journal of Internal Medicine, 256, 240–246.CrossRefGoogle Scholar
World Health Organization (1993). The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva: World Health Organization.Google Scholar