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Spatial Navigation and Its Association With Biomarkers and Future Dementia in Memory Clinic Patients Without Dementia
Tangen GG, Nilsson MH, Stomrud E, Palmqvist S, Hansson O.. Neurology, 2022-08-26
Topic: Risk, prevention and care in population studies
Background and objectives Impaired spatial navigation is considered an early sign in many neurodegenerative diseases. We aimed to determine whether spatial navigation was associated with future dementia in patients with subjective cognitive decline (SCD) or mild cognitive impairment (MCI) and to explore associations between spatial navigation and biomarkers of Alzheimer disease (AD) and neurodegeneration. Methods This study included memory clinic patients without dementia in the longitudinal BioFINDER cohort. The Floor Maze Test (FMT) was used to assess spatial navigation at baseline. Conversion to dementia was evaluated at 2-year and 4-year follow-ups. At baseline, amyloid-β 42/40 ratio, phosphorylated-tau (P-tau), and neurofilament light (NfL) were analyzed in CSF. Cortical thickness and volume of regions relevant for navigation and white matter lesion volume were quantified from MRI. The predictive role of the FMT for conversion to all-cause dementia was analyzed using logistic regression analyses in 2 models: (1) controlled for age, sex, and education and (2) adding baseline cognitive status and MMSE. Associations between FMT and biomarkers were adjusted for age, sex, and cognitive status (SCD or MCI). Results One hundred fifty-six patients with SCD and 176 patients with MCI were included. FMT total time was associated with progression to all-cause dementia in model 2 at 2-year (OR 1.10, 95% CI 1.04-1.16) and at 4-year follow-up (OR 1.10, 95% CI 1.04-1.16), i.e., a 10% increase in odds of developing dementia per every 10 seconds increase in FMT. In the adjusted analyses, P-tau and NfL were associated with FMT total time, as well as hippocampal volume, parahippocampal, and inferior parietal cortical thickness. Amyloid-β 42/40 ratio was not associated with FMT total time. Discussion Impaired spatial navigation was associated with conversion to dementia within 2 and 4 years and with key CSF and MRI biomarkers for AD and neurodegeneration in patients with SCD and MCI. This supports its use in early cognitive assessments, but the predictive accuracy should be validated in other cohorts. Classification of evidence This is a Class I prospective cohort study demonstrating association of baseline markers of spatial recognition with development of dementia in patients with SCD or MCI at baseline.
Key findings
- We aimed to determine whether spatial navigation was associated with future dementia in patients with subjective cognitive decline (SCD) or mild cognitive impairment (MCI) and to explore associations between spatial navigation and biomarkers of Alzheimer disease (AD) and neurodegeneration.
- Results One hundred fifty-six patients with SCD and 176 patients with MCI were included.
- FMT total time was associated with progression to all-cause dementia in model 2 at 2-year (OR 1.10, 95% CI 1.04-1.16) and at 4-year follow-up (OR 1.10, 95% CI 1.04-1.16), i.e., a 10% increase in odds of developing dementia per every 10 seconds increase in FMT.
- In the adjusted analyses, P-tau and NfL were associated with FMT total time, as well as hippocampal volume, parahippocampal, and inferior parietal cortical thickness.
- Amyloid-β 42/40 ratio was not associated with FMT total time.
Why it matters
In 156 people with subjective cognitive decline and 176 with mild cognitive impairment, slower performance on a floor maze test was associated with progression to all-cause dementia at 2-year follow-up. This concerns a possible early marker of dementia risk, not a treatment, cure or prevention.
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Study details
- Study designcohort study
- Participants176
- Effect sizeOR 1.10
- Evidence strengthModerate
How this study scored 65/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2022 — within 6 year(s) of the newest study here |
| Sample size | 2 / 4 | 176 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 38 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.3 citations a year over 6 year(s) since 2022 |
| Impact for its field and year | 3 / 6 | Cited 4.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 2 / 4 | Cited 31 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Oskar Hansson: h-index 148 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Lund University: institution h-index 1,119 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 36028328) |
| Free to read | 2 / 2 | Free to read |
| Total | 65 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Tangen, G. G., Nilsson, M. H., Stomrud, E., Palmqvist, S., & Hansson, O. (2022). Spatial Navigation and Its Association With Biomarkers and Future Dementia in Memory Clinic Patients Without Dementia. Neurology. https://doi.org/10.1212/wnl.0000000000201106
Vancouver
Tangen GG, Nilsson MH, Stomrud E, Palmqvist S, Hansson O. Spatial Navigation and Its Association With Biomarkers and Future Dementia in Memory Clinic Patients Without Dementia. Neurology. 2022. doi:10.1212/wnl.0000000000201106. PMID: 36028328.
BibTeX
@article{tangen2022-36028328,
author = {Tangen, G. G. and Nilsson, M. H. and Stomrud, E. and Palmqvist, S. and Hansson, O.},
title = {{Spatial Navigation and Its Association With Biomarkers and Future Dementia in Memory Clinic Patients Without Dementia}},
journal = {Neurology},
year = {2022},
doi = {10.1212/wnl.0000000000201106},
pmid = {36028328},
url = {https://doi.org/10.1212/wnl.0000000000201106}
}
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