Beyond traditional assessments of cognitive status: Exploring the potential of spatial navigation tasks

Deficits in spatial and navigation abilities are among the earliest signs of dementia. Yet, traditional neuropsychological tests primarily target memory and attention. The Spatial Performance Assessment for Cognitive Evaluation (SPACE) is a novel gamified digital assessment for iPads that uses various spatial tasks to detect early deficits in spatial navigation abilities indicative of cognitive impairment. In this study, 348 participants aged 21-76 completed the Montreal Cognitive Assessment (MoCA), SPACE, and a sociodemographic and health questionnaire. We investigated whether SPACE could predict scores on the MoCA beyond known risk factors for cognitive impairment. Using a factor analysis, we then assessed whether SPACE could complement the MoCA by capturing latent variables independent of MoCA scores that represent additional spatial aspects of cognitive functioning. Results from a hierarchical regression revealed that the pointing and perspective-taking tasks in SPACE significantly predicted MoCA scores beyond age and gender. Surprisingly, none of the risk factors predicted MoCA scores. The factor analysis revealed that the MoCA and perspective-taking contributed to a separate factor from the other navigation tasks in SPACE. We also provide normative data on age and gender for each task in SPACE, which can serve as benchmarks for future studies to identify individuals at risk.