@article{d9de0a8e8aa64636882bfb05538f1400,
title = "Spatial navigation ability predicts progression of dementia symptomatology",
abstract = "Introduction: Spatial navigation deficits are observed in Alzheimer's disease cross-sectionally, but prediction of longitudinal clinical decline has been less examined. Methods: Cognitive mapping (CM) was assessed in 95 participants and route learning (RL) was assessed in 65 participants at baseline. Clinical progression over an average of 4 to 5 years was assessed using the clinical dementia rating (CDR) scale. Relative predictive ability was compared to episodic memory, hippocampus, and cerebrospinal fluid biomarkers (phosphorylated tau/amyloid β 42 (ptau181/Aβ42) ratio). Results: CM and RL were predictors of clinical progression (P{\textquoteright}s < 0.032). All measures, except RL-Learning remained predictors with episodic memory in models (P{\textquoteright}s < 0.048). Only RL-Retrieval remained a predictor when ptau181/Aβ42 was included (P < 0.001). CM interacted with hippocampus and ptau181/Aβ42 in prediction (P{\textquoteright}s < 0.013). CM, RL, and episodic memory evidenced strong diagnostic accuracy (area under the curve (AUC) = 0.894, 0.794, and 0.735, respectively); CM tended to perform better than episodic memory (P = 0.056). Discussion: Baseline spatial navigation performance may be appropriate for assessing risk of clinical progression.",
keywords = "Allocentric, amyloid, egocentric, place learning, preclinical Alzheimer's disease, response learning",
author = "Levine, {Taylor F.} and Allison, {Samantha L.} and Marta Stojanovic and Fagan, {Anne M.} and Morris, {John C.} and Denise Head",
note = "Funding Information: Anne M. Fagan is supported by National Institutes of Health (NIH) grants including P50AG005681, P01AG003991, P01AG026276, and UF01AG03243807. She is on the Scientific Advisory Boards for Roche Diagnostics, AbbVie, and Genentech, and consults for Araclon Biotech/Griffols, Biogen, and DiamiR. John C. Morris is funded by NIH grants P50AG005681; P01AG003991; P01AG026276, and UF1AG032438. Neither Dr. Morris nor his family owns stock or has equity interest (outside of mutual funds or other externally directed accounts) in any pharmaceutical or biotechnology company. Funding Information: This work was supported by NIH grants P50 AG05861, P01 AG03991, P01 AG026276; Spring 2015 Association for Psychological Science Student Grant; 2015 Society for Clinical Neuropsychology Dissertation Award; and 2015 Psychological and Brain Sciences Dissertation Grant. Taylor F. Levine was supported by the National Science Foundation DGE-1745038. Samantha L. Allison was supported by National Institute on Aging 5T32AG00030. We thank the Knight ADRC Biomarker Core for CSF analysis, the Clinical Core for participant assessments, and the Imaging Core for MRI data. We thank Chauncey Scott, Tyler Blazey, and Chiharu Johnston for assistance with the development of the virtual maze environments and programming the virtual maze tasks. Funding Information: This work was supported by NIH grants P50 AG05861, P01 AG03991, P01 AG026276; Spring 2015 Association for Psychological Science Student Grant; 2015 Society for Clinical Neuropsychology Dissertation Award; and 2015 Psychological and Brain Sciences Dissertation Grant. Taylor F. Levine was supported by the National Science Foundation DGE‐1745038. Samantha L. Allison was supported by National Institute on Aging 5T32AG00030. We thank the Knight ADRC Biomarker Core for CSF analysis, the Clinical Core for participant assessments, and the Imaging Core for MRI data. We thank Chauncey Scott, Tyler Blazey, and Chiharu Johnston for assistance with the development of the virtual maze environments and programming the virtual maze tasks. Publisher Copyright: {\textcopyright} 2019 the Alzheimer's Association",
year = "2020",
month = mar,
day = "1",
doi = "10.1002/alz.12031",
language = "English",
volume = "16",
pages = "491--500",
journal = "Alzheimer's and Dementia",
issn = "1552-5260",
number = "3",
}