A new test for topographic disorientation in elderly people. Preliminary results in a healthy sample

In the physiological aging, a reduction in processing speed, episodic memory and working memory have been well established. However, little is known about navigational abilities in elderly people and a few ecological tools are available. Recently, some evidences (Cushman & Stein, 2008; Hort et al., 2007) have suggested topographic disorientation (TD) as a possible marker of conversion from amnesic Mild Cognitive Impairment (a-MCI) to Alzheimer’s disease (AD). The purpose of this research was to create a new ecological instrument in healthy elderly subjects to be subsequently used in clinical setting. Sample: 38 healthy volunteer participants were enrolled, mean age 67.05 (SD = 8.06), 18 males and 15 females. All of them were right-handed. Instruments: a neuropsychological standard battery and experimental tasks that consist of Bidimensional stimuli and the Plastic City with several subtests have been administered. The role of cognitive reserve in navigation abilities has been also evaluated by a recent standardized questionnaire (CRIq) (Nucci, Mondini & Mapelli, 2011). Results: significant correlations among the experimental tests, spatial planning tasks and executive functions have been found. In navigation testing, no differences were detected according to gender, while age resulted to play an important role. Younger elderly showed better performances in execution times, learning of different paths and remembering landmarks met in the previous way. Participants who made many navigational mistakes showed worse scores in cognitive reserve and in visual-spatial memory task (Map Replacement, Recall Replacement on Map and Bidimensional stimuli). Conclusion: according to the previous studies (deIpolyi, Rankin, Mucke, Miller & Gorno-Tempini, 2007; Cushman & Stein, 2008), remembering the correct place of landmarks seems to be an important ability in orientation, along with age and cognitive reserve. These preliminary interesting results support going on the research in elderly navigation; however the Plastic City needs to be improved and subsequently test and re-test. In future research, the Plastic City deserves to be applied also in MCI and early AD patients.