Spatial navigation and risk of cognitive impairment: A prospective cohort study

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.