Background: Great effort has been put into developing simple and feasible tools capable to
detect Alzheimer's disease (AD) in its early clinical stage. Spatial navigation impairment occurs very
early in AD and is detectable even in the stage of mild cognitive impairment (MCI).
Objective: The aim was to describe the frequency of self-reported spatial navigation complaints in patients
with subjective cognitive decline (SCD), amnestic and non-amnestic MCI (aMCI, naMCI) and AD
dementia and to assess whether a simple questionnaire based on these complaints may be used to detect
Method: In total 184 subjects: patients with aMCI (n=61), naMCI (n=27), SCD (n=63), dementia due to
AD (n=20) and normal controls (n=13) were recruited. The subjects underwent neuropsychological examination
and were administered a questionnaire addressing spatial navigation complaints. Responses to
the 15 items questionnaire were scaled into four categories (no, minor, moderate and major complaints).
Results: 55% of patients with aMCI, 64% with naMCI, 68% with SCD and 72% with AD complained
about their spatial navigation. 38-61% of these complaints were moderate or major. Only 33% normal
controls expressed complaints and none was ranked as moderate or major. The SCD, aMCI and AD dementia
patients were more likely to express complaints than normal controls (p's<0.050) after adjusting
for age, education, sex, depressive symptoms (OR for SCD=4.00, aMCI=3.90, AD dementia=7.02) or
anxiety (OR for SCD=3.59, aMCI=3.64, AD dementia=6.41).
Conclusion: Spatial navigation complaints are a frequent symptom not only in AD, but also in SCD and
aMCI and can potentially be detected by a simple and inexpensive questionnaire.