Topographical disorientation in aging. Familiarity with the environment does matter

Long-lasting pure topographical disorientation due to heading disorientation following left retrosplenial infarction: A report of two cases

Topographical disorientation is linked to lesions in the right hemisphere and typically resolves within a few months post-stroke. Persistent topographical disorientation is uncommon and frequently accompanied by impairments in visual memory, complicating the analysis of the underlying mechanisms. Herein, we report two cases of sustained pure topographical disorientation following cerebral hemorrhages in the left retrosplenial region. The patients exhibited disorientation in both familiar and unfamiliar settings, attributable to heading disorientation, a deficit in determining the directional relationship between one's current position and a target location or external frames. The patients struggled with reconstructing large-scale spatial frameworks and integrating new egocentric and allocentric perspectives upon changes in body orientation. There were no landmark agnosia, egocentric disorientation, or anterograde disorientation. Although mild verbal memory deficits were observed, no other cognitive impairments, including visual memory deficits, were detected. Our findings imply that lesions confined to the left retrosplenial region can induce enduring heading disorientation and suggest a significant role for this area in processing and integrating spatial information necessary for large-scale navigation. Clarifying the features of topographical disorientation will significantly impact the therapeutic approaches, enhancing the quality of life for affected patients by restoring their independence and mobility.

Behavioral Disorders of Spatial Cognition in Patients with Mild Cognitive Impairment Due to Alzheimer's Disease (The BDSC-MCI Project): Ecological Validity of the Corsi Learning Suvra-Span Test

BACKGROUND

Spatial navigation deficits are reported as early symptoms of Alzheimer's disease (AD) alongside episodic memory ones. The aim of the present study was to ascertain whether neuropsychological deficits of visuospatial long-term memory can predict behavioral alterations during the navigation of older adults in novel urban environments along the normal aging-dementia continuum of the Alzheimer's type.

METHODS

A total of 24 community-dwelling patients with Mild Cognitive Impairment (MCI) due to AD, 27 individuals with subjective cognitive decline (SCD), and 21 healthy controls were assessed in terms of their sequential egocentric and allocentric navigation abilities by using a modified version of the Detour Navigation Test, and neuropsychologically tested by the Corsi learning suvra-span (CLSS) test. Generalized linear models were adopted to verify whether the scores obtained by the three groups in the CLSS test predicted wrong turns and moments of hesitation during the navigation task, with the results presented as topographical disorientation scores.

RESULTS

Higher scores in the CLSS test predicted fewer wrong turns (b = -0.05; z = -2.91; p = 0.004; net of between-groups differences) and moments of hesitation for patients with MCI due to AD (b = -0.14; z = -2.43; p = 0.015), and individuals with SCD (b = -0.17; z = -3.85; p < 0.001).

CONCLUSIONS

Since the CLSS test has been reported to be a reliable measure of ecological navigational abilities in the progression towards AD dementia, we recommend its use in clinical practice and highlight implications for future research.

The neural correlates of topographical disorientation-a lesion analysis study

Topographical disorientation refers to the selective inability to orient oneself in familiar surroundings. However, to date its neural correlates remain poorly understood. Here we use quantitative lesion analysis and a lesion network mapping approach in order to investigate seven patients with topographical disorientation. Our findings link not only the posterior parahippocampal gyrus (PHG) and retrosplenial cortex but also the lingual gyrus, the precuneus and the fusiform gyrus to topographical disorientation. We propose that topographical disorientation is due to the inability to integrate familiar landmarks within a framework of allocentric and egocentric orientation, supported by a neural network including the posterior PHG, the retrosplenial and the lingual cortex.

The experiences of people living with dementia and their care partners participating in an online therapeutic songwriting program

BACKGROUND AND AIM

Despite the impact of dementia on close care relationships, accessible therapeutic services for people living with dementia and their care partners remain scarce. Further, there is an increasing demand for online services, highlighting the need for ongoing telehealth research. This study aimed to explore the experiences of people living with dementia and their informal and formal care partners following participation in a 10-week online therapeutic songwriting program.

METHODS

The songwriting program included four duo and six group sessions facilitated by a music therapist. Post-program semi-structured interviews were analysed using thematic analysis.

FINDINGS

Nine people with dementia and six care partners (nine duos) participated in the program. Five duos were in spousal relationships and four people with dementia participated with a formal care partner. Participants attended an average of four duo sessions and three group sessions. Six people with dementia and five care partners participated in post-program interviews. Four themes were developed: (1) No one else does this; (2) It's all about us as people; (3) After the sessions we'd come out buzzing; and (4) The journey was as important as the product.

CONCLUSIONS

Participants highlighted songwriting as a unique opportunity to connect with music, experience welcomed challenges, and spend 'real time' together. The program drew on participants' lived experience and promoted connection with others, resulting in feelings of enjoyment, enhanced mood, and achievement. Participants valued both the songwriting process and song product, emphasising the importance of sensitive and skilful facilitation. Our findings suggest that these distinct benefits were not available through other support services. Further, online songwriting is a viable option for people living with dementia and their care partners where in-person sessions are not available or accessible.

Orienteering experts report more proficient spatial processing and memory across adulthood

The closest surrogate to hunter-gather activity is the sport of orienteering, which naturally and simultaneously combines high-intensity interval exercise with navigation. Although human cognition can be improved across the lifespan through exercise and cognitive training, interventions like orienteering may be especially effective because they resemble activities engaged in by prehistoric humans during evolution. The present study tested whether orienteering experts have better hippocampal-dependent cognitive function than active, non-orienteering controls. One-hundred and fifty-eight healthy adults between the ages of 18 and 87 years old with varying experience in orienteering (none, intermediate, advanced, elite) reported on their spatial processing, spatial memory and episodic memory using the Navigational Strategy Questionnaire and the Survey of Autobiographical Memory. Orienteering experts reported greater use of allocentric and egocentric spatial processing and better spatial memory than controls. In contrast, episodic memory was not associated with orienteering expertise. Notably, the significant effects of orienteering on spatial cognition remained even after controlling for age, sex, and physical activity, suggesting that orienteering may be an effective intervention to prevent age-related cognitive decline in spatial navigation and memory.

“Where am I?” A snapshot of the developmental topographical disorientation among young Italian adults

In the last decade, several cases affected by Developmental Topographical Disorientation (DTD) have been described. DTD consists of a neurodevelopmental disorder affecting the ability to orient in the environment despite well-preserved cognitive functions, and in the absence of a brain lesion or other neurological or psychiatric conditions. Described cases showed different impairments in navigational skills ranging from topographic memory deficits to landmark agnosia. All cases lacked a mental representation of the environment that would allow them to use high-order spatial orientation strategies. In addition to the single case studies, a group study performed in Canada showed that the disorder is more widespread than imagined. The present work intends to investigate the occurrence of the disorder in 1,698 young Italian participants. The sample is deliberately composed of individuals aged between 18 and 35 years to exclude people who could manifest the loss of the ability to navigate as a result of an onset of cognitive decline. The sample was collected between 2016 and 2019 using the Qualtrics platform, by which the Familiarity and Spatial Cognitive Style Scale and anamnestic interview were administered. The data showed that the disorder is present in 3% of the sample and that the sense of direction is closely related to town knowledge, navigational strategies adopted, and gender. In general, males use more complex navigational strategies than females, although DTD is more prevalent in males than in females, in line with the already described cases. Finally, the paper discusses which protective factors can reduce DTD onset and which intervention measures should be implemented to prevent the spread of navigational disorders, which severely impact individuals’ autonomy and social relationships.

Walking on a minefield: planning, remembering, and avoiding obstacles: preliminary findings

Travel planning (TP) is a kind of planning devoted to spatial orientation that is distinguishable from general planning (GP). It is crucial to reach a destination, since it allows to select the best route according to the environmental features (e.g., the one with little traffic or the safest). TP is also needed to avoid obstacles along the way and to put in place effective strategies to support navigation. TP involves several cognitive processes, such as visuo-spatial and topographic memory as well as other executive functions (i.e., general planning, cognitive flexibility, problem solving, and divergent thinking) and it is affected by internal factors (such as gender, cognitive strategies, age). Here, we focused on the effects of visuo-spatial (VSWM) and topographic (TWM) working memory on TP, using the Minefield Task (MFT), a new tool aimed at testing TP. We tested VSWM, TWM, GP, and TP in 44 college students. First, we checked for gender differences in all the tasks proposed and then assessed the relation among VSWM, TWM, GP, and TP. Results showed that even though gender difference could be found on TWM, GP, and TP, significative correlations emerged among TP, VSWM, and GP as well as a tendency to significance for VSWM and GP in the regression analyses. Though more evidence is needed, these results suggest that when a brand-new route is computed, GP and VSWM can be the most relevant processes, whereas topographic memory was less involved, probably because the MFT does not require to recall a route from memory. The implications of these results in clinical settings are discussed.

Behavioral and Psychological Symptoms of Dementia as a Means of Communication: Considerations for Reducing Stigma and Promoting Person-Centered Care

Dementia has rapidly become a major global health crisis. As the aging population continues to increase, the burden increases commensurately on both individual and societal levels. The behavioral and psychological symptoms of dementia (BPSD) are a prominent clinical feature of Alzheimer’s disease and related dementias (ADRD). BPSD represent a myriad of manifestations that can create significant challenges for persons living with dementia and their care providers. As such, BPSD can result in detriments to social interaction with others, resulting in harm to the psychosocial health of the person with dementia. While brain deterioration can contribute to BPSD as the disease progresses, it may be confounded by language and communication difficulties associated with ADRD. Indeed, when a person with dementia cannot effectively communicate their needs, including basic needs such as hunger or toileting, nor symptoms of pain or discomfort, it may manifest as BPSD. In this way, a person with dementia may be attempting to communicate with what little resources are available to them in the form of emotional expression. Failing to recognize unmet needs compromises care and can reduce quality of life. Moreover, failing to fulfill said needs can also deteriorate communication and social bonds with loved ones and caregivers. The aim of this review is to bring the differential of unmet needs to the forefront of BPSD interpretation for both formal and informal caregivers. The overarching goal is to provide evidence to reframe the approach with which caregivers view the manifestations of BPSD to ensure quality of care for persons with dementia. Understanding that BPSD may, in fact, be attempts to communicate unmet needs in persons with dementia may facilitate clinical care decisions, promote quality of life, reduce stigma, and foster positive communications.

Flexible Use of Spatial Frames of Reference for Object-Location Memory in Older Adults

In memory, representations of spatial features are stored in different reference frames; features relative to our position are stored egocentrically and features relative to each other are stored allocentrically. Accessing these representations engages many cognitive and neural resources, and so is susceptible to age-related breakdown. Yet, recent findings on the heterogeneity of cognitive function and spatial ability in healthy older adults suggest that aging may not uniformly impact the flexible use of spatial representations. These factors have yet to be explored in a precisely controlled task that explicitly manipulates spatial frames of reference across learning and retrieval. We used a lab-based virtual reality task to investigate the relationship between object-location memory across frames of reference, cognitive status, and self-reported spatial ability. Memory error was measured using Euclidean distance from studied object locations to participants' responses at testing. Older adults recalled object locations less accurately when they switched between frames of reference from learning to testing, compared with when they remained in the same frame of reference. They also showed an allocentric learning advantage, producing less error when switching from an allocentric to an egocentric frame of reference, compared with the reverse direction of switching. Higher MoCA scores and better self-assessed spatial ability predicted less memory error, especially when learning occurred egocentrically. We suggest that egocentric learning deficits are driven by difficulty in binding multiple viewpoints into a coherent representation. Finally, we highlight the heterogeneity of spatial memory performance in healthy older adults as a potential cognitive marker for neurodegeneration, beyond normal aging.

Vision through Healthy Aging Eyes

As life expectancy grows, so too will the number of people adversely affected by age. Although it is acknowledged that many conditions and diseases are associated with age, this mini-review will present a current update of the various visual changes that generally occur in healthy individuals disregarding the possible effects of illness. These alterations influence how the world is perceived and in turn can affect efficiency or the ability to perform ordinary daily tasks such as driving or reading. The most common physical developments include a decreased pupil size and retinal luminance as well as changes both in intercellular and intracellular connections within the retina along the pathway to the visual cortex and within the visual cortex. The quantity and the physical location of retinal cells including photoreceptors, ganglion and bipolar retinal cells are modified. The clarity of intraocular organs, such as the intraocular lens, decreases. These all result in common visual manifestations that include reduced visual acuity, dry eyes, motility changes, a contraction of the visual field, presbyopia, reduced contrast sensitivity, slow dark adaptation, recovery from glare, variation in color vision and a decreased visual processing speed. Highlighting these prevalent issues as well as current and possible future innovations will assist providers to formulate treatments and thereby conserve maximum independence and mobility in the modern mature population.

Do Advanced Spatial Strategies Depend on the Number of Flight Hours? The Case of Military Pilots

BACKGROUND

Military pilots show advanced visuospatial skills. Previous studies demonstrate that they are better at mentally rotating a target, taking different perspectives, estimating distances and planning travel and have a topographic memory. Here, we compared navigational cognitive styles between military pilots and people without flight experience. Pilots were expected to be more survey-style users than nonpilots, showing more advanced navigational strategies.

METHOD

A total of 106 military jet pilots from the Italian Air Force and 92 nonpilots from the general population matched for education with the pilots were enrolled to investigate group differences in navigational styles. The participants were asked to perform a reduced version of the Spatial Cognitive Style Test (SCST), consisting of six tasks that allow us to distinguish individuals in terms of landmark (people orient themselves by using a figurative memory for environmental objects), route (people use an egocentric representation of the space) and survey (people have a map-like representation of the space) user styles.

RESULTS

In line with our hypothesis, military pilots mainly adopt the survey style, whereas nonpilots mainly adopt the route style. In addition, pilots outperformed nonpilots in both the 3D Rotation Task and Map Description Task.

CONCLUSIONS

Military flight expertise influences some aspects of spatial ability, leading to enhanced human navigation. However, it must be considered that they are a population whose navigational skills were already high at the time of selection at the academy before formal training began.

The Role of Gender and Familiarity in a Modified Version of the Almeria Boxes Room Spatial Task

Individual factors like gender and familiarity can affect the kind of environmental representation that a person acquires during spatial navigation. Men seem to prefer relying on map-like survey representations, while women prefer using sequential route representations. Moreover, a good familiarity with the environment allows more complete environmental representations. This study was aimed at investigating gender differences in two different object-position learning tasks (i.e., Almeria Boxes Tasks) assuming a route or a survey perspective also considering the role of environmental familiarity. Two groups of participants had to learn the position of boxes placed in a virtual room. Participants had several trials, so that familiarity with the environment could increase. In both tasks, the effects of gender and familiarity were found, and only in the route perspective did an interaction effect emerge. This suggests that gender differences can be found regardless of the perspective taken, with men outperforming women in navigational tasks. However, in the route task, gender differences appeared only at the initial phase of learning, when the environment was unexplored, and disappeared when familiarity with the environment increased. This is consistent with studies showing that familiarity can mitigate gender differences in spatial tasks, especially in more complex ones.

Usefulness of navigation application for outdoor mobility guides in community-dwelling older adults: a preliminary study

PURPOSE

This study aimed to examine a mobile device navigation application's (apps) usefulness as a guide based on the required time and accuracy of moving to a destination for community-dwelling older adults.

METHODS

Twelve older adults, aged ≥65 years (mean age 77.0 ± 8.0, 62% female) who used the day-care centre for older adults, based on the long-term care insurance system in Kagoshima Prefecture, participated in this study. Study participants performed a Route Navigation Task (RNT), which is a simple real-world navigation test based on the actual living environment, after a brief assessment of physical function, cognitive function, and daily living routine. RNT required that participants arrive at a destination for the shortest time, under three tasks: map-, app-, and photo-language. The order of implementation of each task, determined by one of the tasks, was randomized, with a span of a minimum 1 month between tasks.

RESULTS

The app-task resulted in a significantly shorter amount of travel time than did the other tasks (p < 0.05). The factors considerably correlating with travel time in the app-task were walking speed, mobile device proficiency, years of mobile device use, and higher-order activities of daily living.

CONCLUSION

Our findings suggested the possibility that the navigation app was useful as efficient outdoor mobility support, and healthcare providers should encourage the use of mobile devices for improving the active lifestyle of the community-dwelling older adults.IMPLICATIONS FOR REHABILITATIONThe navigation apps in mobile devices are expected to be useful for community-dwelling older adults.We examined the effect of navigation app use on path execution using three tasks in RNT and what factors are associated with the ability of route navigation.A significant reduction in travel time when RNT was performed using a navigation app compared to the other two tasks (map, photo-language).Regardless of cognitive function, mobile device proficiency, and mobile device usage were associated with navigation app use.This study suggests the usefulness of a navigation application in providing route assistance to community-dwelling older adults.

The Road More Travelled: The Differential Effects of Spatial Experience in Young and Elderly Participants

Our spatial mental representations allow us to give refined descriptions of the environment in terms of the relative locations and distances between objects and landmarks. In this study, we investigated the effects of familiarity with the everyday environment, in terms of frequency of exploration and mode of transportation, on categorical and coordinate spatial relations, on young and elderly participants, controlling for socio-demographic factors. Participants were tested with a general anamnesis, a neuropsychological assessment, measures of explorations and the Landmark Positioning on a Map task. The results showed: (a) a modest difference in performance with categorical spatial relations; (b) a larger difference in coordinate spatial relations; (c) a significant moderating effect of age on the relationship between familiarity and spatial relations, with a stronger relation among the elderly than the young. Ceteris paribus, the role of direct experience with exploring their hometown on spatial mental representations appeared to be more important in the elderly than in the young. This advantage appears to make the elderly wiser and likely protects them from the detrimental effects of aging on spatial mental representations.

The impact of age and familiarity with the environment on categorical and coordinate spatial relation representations

Retrieving spatial information is a crucial everyday ability that is affected by age-related changes. Previous research has shown that this change is mediated by familiarity with an environment. The present research uses a series of landmark location tasks to extend and deepen our understanding of the role of aging in spatial mental representations of more or less familiar environments, also disentangling the contribution of coordinate and categorical spatial relations. The study tested the following hypotheses: (1) younger adults only have an advantage over the elderly in less familiar environments; (2) the advantage for categorical over coordinate spatial relations is mainly found for less familiar environments; and finally; (3) interactions between age, familiarity, and spatial relations might reveal that the effects of age and familiarity take different trajectories for coordinate and categorical spatial relations. Results confirmed that: (1) young people outperform the elderly only in less familiar environments; (2) there is a reduction in the difference between coordinate and categorical accuracy with increasing familiarity with the environment; while (3) the interaction between age and level of familiarity did not significantly differentiate coordinate from categorical spatial relations. In conclusion, the present study provides new evidence for the role of familiarity with geographical areas and its impact on the representation of categorical and coordinate relations, with practical implications for the assessment of topographical disorientation in aging.

Studying Individual Differences in Spatial Cognition Through Differential Item Functioning Analysis

Background: In the field of spatial cognition, the study of individual differences represents a typical research topic. Gender and age have been prominently investigated. A promising statistical technique used to identify the different responses to items in relation to different group memberships is the Differential Item Functioning Analysis (DIF). The aim of the present study was to investigate the DIF of the Landmark positioning on a Map (LPM) task, across age groups (young and elderly) and gender, in a sample of 400 healthy human participants. Methods: LPM is a hometown map completion test based on well-known and familiar landmarks used to assess allocentric mental representations. DIF was assessed on LPM items two times: on categorical (i.e., positions) and coordinate (i.e., distances) scores, separately. Results: When positions and distances were difficult to assess with respect to the intended reference point, the probability to endorse the items seemed to get worse for the elderly compared to the younger participants. Instead other features of landmarks (high pleasantness, restorativeness) seemed to improve the elderly performance. A gender-related improvement of probability to endorse distance estimation of some landmarks, favoring women, emerged, probably associated with their repeated experiences with those landmarks. Overall, the complexity of the task seemed to have a differential impact on young and elderly people while gender-oriented activities and places seemed to have a differential impact on men and women. Conclusions: For the first time DIF was applied to a spatial mental representation task, based on the schematic sketch maps of the participants. The application of DIF to the study of individual differences in spatial cognition should become a systematic routine to early detect differential items, improving knowledge, as well as experimental control, on individual differences.

The Relationship between Emotionally Laden Landmarks, Spatial Abilities, and Personality Traits: An Exploratory Study

Separate research lines have shown that the way we process spatial information is influenced by individual factors, such as personality traits and basic spatial abilities. Alongside, recent studies suggest that environmental landmarks can be represented differently depending on their emotional content. However, to our knowledge, no study has addressed so far the issue of whether there is a relationship between individual factors and the way we represent and use spatial information that conveys emotional content. Therefore, this exploratory study aimed to (i) investigate the relationship between personality traits and the use of spatial strategies in relation to emotional stimuli; (ii) investigate if a different pattern emerges according to a body- or object-based spatial encodings. After watching movies of routes characterized by positive, negative, or neutral landmarks, participants performed a "route continuation" (RC, i.e., left/right decision) and a "distance comparison" task (DC, i.e., what was the landmark closest to X?). Furthermore, participants performed a mental rotation task (MR), the Corsi block tapping (CBT), and the Bergen right-left discrimination tests (B-RL). Personality traits were assessed through the Ten Item Personality Inventory (TIPI). Results showed that a better performance at the RC task was associated with higher scores at CBT tasks in the positive condition and at B-RL test and agreeableness scale from TIPI in both positive and neutral conditions. Instead, the MR task positively correlated with the DC task in all conditions. In sum, individuals' spatial abilities, personality traits, and task requests influenced the way emotionally laden landmarks were memorized.

The differential effect of normal and pathological aging on egocentric and allocentric spatial memory in navigational and reaching space

BACKGROUND

Topographical disorientation (TD) refers to a particular condition which determines the loss of spatial orientation, both in new and familiar environments. TD and spatial memory impairments occur relatively early as effect of cognitive decline in aging, even in prodromal stages of dementia, namely mild cognitive impairment (MCI).

AIMS

(a) To show that components linked to the recall of familiar spatial knowledge are relatively spared with respect to the learning of unfamiliar ones in normal aging, while they are not in MCI, and (b) to investigate gender differences for their impact on egocentric and allocentric frames of reference.

METHOD

Forty young participants (YC), 40 healthy elderly participants (HE), 40 elderly participants with subjective memory complaints (SMC), and 40 elderly with probable MCI were administered with egocentric and allocentric familiar tasks, based on the map of their hometown, and with egocentric and allocentric unfamiliar tasks, based on new material to be learned. A series of general linear models were used to analyze data.

RESULTS

No group differences were found on egocentric task based on familiar information. MCI performed worse than the other groups on allocentric tasks based on familiar information (YC = HE = SMC > MCI). Significant differences emerged between groups on egocentric and allocentric tasks based on unfamiliar spatial information (YC > HE = SMC > MCI). A gender difference was found, favoring men on allocentric unfamiliar task.

CONCLUSION

Familiarity of spatial memory traces can represent a protective factor for retrospective components of TD in normal aging. Conversely, using newly learned information for assessment may lead to overestimating TD severity.

Pure topographical disorientation in novel environments without anterograde amnesia: a case study

Topographical disorientation (TD) in novel environments is considered to be a part of anterograde amnesia. A 56-year-old woman presented with pure TD only in novel environments following limbic encephalitis. She could not remember directions inside the hospital on weekly outpatient visits; however, her verbal and visual anterograde memories were normal. In the test of learning photographs of scenes, faces, and objects, only her scores for landscapes were worse than those in healthy controls. These findings suggested that her TD specific to landscapes and directions in novel environments was caused by category-specific memory impairment related to bilateral hippocampal and parahippocampal dysfunction.

Signs and symptoms method in neuropsychology: A preliminary investigation of a standardized clinical interview for assessment of cognitive decline in dementia

Psychologists usually perform a preliminary assessment of the person's cognitive status through a brief interview conducted before the formal testing. However, this exam has not yet been standardized with ad hoc recommendations in psychology literature. In this work, a standard observational NeuroPsychological Examination (NPE) designed for psychologists was proposed, and its clinical effectiveness evaluated. The NPE was administered to patients referred to a neuropsychological service in a memory clinic over a 2-year period. The NPEs of the patients with Alzheimer dementia (AD), vascular dementia (VaD), and healthy controls (HC) were retrospectively retrieved. Comparisons among the three groups were conducted. Abnormalities/signs identified during the NPE in the AD and VaD groups are more numerous compared to those reported in the HC group. About 80% of HCs show none or only one abnormal sign. Vice versa, 87.5% of both AD and VaD patients show three or more abnormalities. Accordingly, the NPE has 0.88 (95%CI = 0.81-0.95) sensitivity and 0.95 (95%CI = 0.88-1.02) specificity for detecting cognitive decline when a cut-point of three or more signs is applied. Some significant differences also emerge on the number of pathological signs between AD and VaD patients. NPE is a promising tool with demonstrated diagnostic utility in dementia patients.

Memory for familiar locations: The impact of age, education and cognitive efficiency on two neuropsychological allocentric tasks

This research aims to reconsider and support the use of spatial tasks based on familiar geographical information in the neuropsychological assessment of topographical (dis)orientation. Performance on two spatial tasks based on familiar information -l andmark positioning on a map and map of Italy - were compared in two studies assessing allocentric orientation among young and healthy elderly with different levels of education (Study 1) and elderly with and without probable cognitive impairment (Study 2). Results from Study 1 showed that the map of Italy task was affected by education, while the landmark positioning on a map was not. Results of Study 2 showed that both tasks were sensitive to different levels of cognitive functioning in a sample of community-dwelling seniors. Overall, spatial tasks based on mental representation of the hometown environment may be an important supplement in the assessment of allocentric topographical disorientation, discriminating typical from atypical aging.

Continuous Environmental Changes May Enhance Topographic Memory Skills. Evidence From L'Aquila Earthquake-Exposed Survivors

Exposure to environmental contextual changes, such as those occurring after an earthquake, requires individuals to learn novel routes around their environment, landmarks and spatial layout. In this study, we aimed to uncover whether contextual changes that occurred after the 2009 L'Aquila earthquake affected topographic memory in exposed survivors. We hypothesized that individuals exposed to environmental changes-individuals living in L'Aquila before, during and after the earthquake (hereafter called exposed participants, EPs)-improved their topographic memory skills compared with non-exposed participants (NEPs) who moved to L'Aquila after the earthquake, as only EPs had to modify their previous cognitive map of L'Aquila. We also hypothesized that memory improvement was selective for the navigational space and did not generalize across other spatial and verbal domains. To test these hypotheses, we compared the topographic and spatial memory skills of 56 EPs without post-traumatic stress disorder (PTSD) symptoms to the skills of 47 NEPs using the Walking Corsi Test (WalCT; memory test in the navigational space) and the Corsi Block-Tapping Test (CBT; visuospatial memory test in the reaching space); EPs and NEPs were matched for gender, education and general navigational skills. A sub-group of participants also underwent the Rey-Auditory Verbal Learning Test (RAVLT; verbal memory test). The results showed that only EPs had better performances on topographic learning (TL) assessed using the WalCT rather than spatial learning assessed by the CBT. This outcome suggests the possibility that EPs specifically improved topographic memory. This effect may be due to continuous exposure to environmental changes that have required individuals to learn novel paths within the city and integrate novel information, such as "new towns," into their pre-existing mental representation of the city. Implications and limitations of the study are discussed.