The modified spatial context memory test for assessing cognitive aging in middle-aged and older adults

Deficits in spatial-context memory may be risk factors for Alzheimer disease (AD). This study aimed to investigate spatial-context memory and spatial navigation in middle-aged and older adults using a modified spatial-context memory test (SCMT). This prospective study recruited adults aged 55-75 years from our outpatient department. Non-dementia cases were confirmed by neurologists and assessed by psychologists. Age and education were analyzed as continuous variables using regression models to examine their associations with SCMT performance. A modified SCMT was established, consisting of a computer program that performed in cooperation with a spatial memory paradigm using real-world simulation. Subtests of navigation, scene-event associations and people-object associations were included. Of 147 participants, 108 met the selection criteria and were included in the analysis. Older age was linked to more errors and longer retrieval times, whereas higher education was related to shorter completion times in some SCMT-I tasks. In conclusion, SCMT-I performance was primarily influenced by age, with older participants showing increased errors and longer retrieval times across subtests. These findings suggest that age-related changes in spatial-context memory can be detected even among cognitively normal adults, and that SCMT-I may provide a sensitive tool for assessing cognitive aging independent of educational background.