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The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease
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Developing a Spatial Navigation Screening Tool Sensitive to the Preclinical Alzheimer Disease Continuum.

Samantha L Allison1, Thomas L Rodebaugh1, Chiharu Johnston1

  • 1Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA.

Archives of Clinical Neuropsychology : the Official Journal of the National Academy of Neuropsychologists
|June 15, 2019
PubMed
Summary

A new self-report questionnaire and a cognitive mapping task show promise for screening preclinical Alzheimer disease (AD). These non-invasive tools can identify individuals with low cerebrospinal fluid (CSF) Aβ42, aiding early detection before invasive procedures.

Keywords:
amyloidcognitionhippocampusptaureliabilityvalidity

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Area of Science:

  • Neuroscience
  • Gerontology
  • Psychometrics

Background:

  • Early detection of Alzheimer disease (AD) is crucial for timely intervention.
  • Current screening methods like lumbar puncture and PET scans are invasive and costly.
  • There is a need for non-invasive, cost-effective screening tools for preclinical AD.

Purpose of the Study:

  • To compare the psychometric properties of six spatial navigation-related tasks.
  • To identify clinically appropriate screening measures for preclinical Alzheimer disease (AD).
  • To develop a non-invasive screening tool for individuals in the preclinical AD continuum.

Main Methods:

  • Examined psychometric properties (reliability, diagnostic accuracy, validity) of modified cognitive mapping, binding, and visual perspective-taking tasks.
  • Utilized self- and informant-report questionnaires.
  • Assessed 91 cognitively normal individuals, with CSF Aβ42 and ptau181 data available for 30.

Main Results:

  • The cognitive mapping task's learning phase demonstrated 93% sensitivity and 60% specificity for preclinical AD.
  • The self-report questionnaire showed 87% sensitivity and 67% specificity.
  • Both measures exhibited good test-retest stability and internal consistency.

Conclusions:

  • A self-report questionnaire and aspects of a cognitive mapping task are suitable for further development as screening tools.
  • These tools can help identify individuals in the preclinical AD continuum.
  • This research advances the development of non-invasive screening for early Alzheimer disease detection.