Joe Verghese1, Richard Lipton2, Emmeline Ayers2. 1. Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA. Electronic address: joe.verghese@einstein.yu.edu. 2. Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
Abstract
INTRODUCTION: Spatial navigation deficits are reported in dementia, but their temporal relationship to cognitive decline is not established. METHODS: This is a prospective cohort study in 442 nondemented adults (mean age 79.9 years). Spatial navigation measured with the Floor Maze Test and reported as immediate maze time (IMT) and delayed maze time (DMT). Predementia syndromes, mild cognitive impairment syndrome (MCI) and motoric cognitive risk syndrome (MCR), were primary outcomes. RESULTS: Over a mean follow-up of 16.5 ± 13.7 months, 41 participants developed MCI and 30 participants developed MCR. In Cox models adjusted for age, sex, education, cognitive status, comorbid illnesses, and maze errors, a 10-second increment on IMT predicted incident MCI (adjusted hazard ratio [aHR]: 1.25; 95% confidence interval [CI]: 1.06-1.48) and MCR (aHR: 1.53; 95% CI: 1.23-1.90). DMT predicted MCR but not MCI. DISCUSSION: Spatial navigation performance predicted predementia syndromes in aging and implicates navigational impairments as an early feature in dementias.
INTRODUCTION: Spatial navigation deficits are reported in dementia, but their temporal relationship to cognitive decline is not established. METHODS: This is a prospective cohort study in 442 nondemented adults (mean age 79.9 years). Spatial navigation measured with the Floor Maze Test and reported as immediate maze time (IMT) and delayed maze time (DMT). Predementia syndromes, mild cognitive impairment syndrome (MCI) and motoric cognitive risk syndrome (MCR), were primary outcomes. RESULTS: Over a mean follow-up of 16.5 ± 13.7 months, 41 participants developed MCI and 30 participants developed MCR. In Cox models adjusted for age, sex, education, cognitive status, comorbid illnesses, and maze errors, a 10-second increment on IMT predicted incident MCI (adjusted hazard ratio [aHR]: 1.25; 95% confidence interval [CI]: 1.06-1.48) and MCR (aHR: 1.53; 95% CI: 1.23-1.90). DMT predicted MCR but not MCI. DISCUSSION: Spatial navigation performance predicted predementia syndromes in aging and implicates navigational impairments as an early feature in dementias.
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