Beyond the Mini-Mental State Examination: The Use of Physical and Spatial Navigation Tests to Help to Screen for Mild Cognitive Impairment and Alzheimer’s Disease

Article type: Research Article

Authors: Plácido, Jessica^a | Ferreira, José Vinicius^a | Araújo, Juliana^a | Silva, Felipe de Oliveira^a | Ferreira, Renan Baltar^b | Guimarães, Carla^b | de Carvalho, Andréa Nunes^b | Laks, Jerson^a | Deslandes, Andrea Camaz^{a; *}

Affiliations: [a] Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil | [b] Instituto Nacional de Tecnologia, Rio de Janeiro, Brazil

Correspondence: [*] Correspondence to: Andrea Camaz Deslandes, Rua Sylvio da Rocha Pollis 300 casa 02, Rio de Janeiro, Brazil. Tel.: +55 21 99726 9778; E-mail: adeslandes@ipub.ufrj.br; http://orcid.org/0000-0001-5941-9111.

Abstract: Background:Spatial navigation and dual-task (DT) performance may represent a low-cost approach to the identification of the cognitive decline in older adults and may support the clinical diagnosis of mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Objective:To assess the accuracy of different types of motor tasks in differentiating older persons with MCI and AD from healthy peers. Methods:Older adults aged 60 years or over (n = 105; healthy = 39; MCI = 23; AD = 43) were evaluated by the floor maze test (FMT), the senior fitness test, and DT performance. Receiver operating characteristic curve (ROC) analysis was used to evaluate the accuracy of the tests. We also performed principal component analysis (PCA) and logistic regression analysis to explore the variance and possible associations of the variables within the sample. Results:FMT (AUC = 0.84, sensitivity = 75.7%, specificity = 76.1%, p < 0.001) and DT (AUC = 0.87, sensitivity = 80.4%, specificity = 86.9%, p < 0.001) showed the highest performance for distinguishing MCI from AD individuals. Moreover, FMT presented better sensitivity in distinguishing AD patients from their healthy peers (AUC = 0.93, sensitivity = 94%, specificity = 85.6%, p < 0.001) when compared to the Mini-Mental State Examination. PCA revealed that the motor test performance explains a total of 73.9% of the variance of the sample. Additionally, the results of the motor tests were not influenced by age and education. Conclusion:Spatial navigation tests showed better accuracy than usual cognitive screening tests in distinguishing patients with neurocognitive disorders.

Keywords: Aerobic capacity, Alzheimer’s disease, biomarkers, dual-task, floor maze test, mild cognitive impairment, physical fitness, spatial navigation

DOI: 10.3233/JAD-210106

Journal: Journal of Alzheimer's Disease, vol. 81, no. 3, pp. 1243-1252, 2021