title: Spatial navigation and risk of cognitive impairment: A prospective cohort study.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  Spatial navigation performance predicted predementia syndromes in aging and implicates navigational impairments as an early feature in dementias.
authors.affiliation: 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.
authors.forename: Joe
authors.initials: J
authors.lastname: Verghese
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Lipton
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Emmeline
authors.initials: E
authors.lastname: Ayers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology* / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D018782:Maze Learning; D009483:Neuropsychological Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D065854:Spatial Navigation / Q000502:physiology*
keywords: Cognitive tests; Dementia; Incidence studies; Mild cognitive impairment syndrome; Motoric cognitive risk syndrome; Navigation