Some people take wide turns when they are walking or driving and get disoriented easily. Some drive slowly, while others are fast and erratic. Some get lost in their own neighborhood or have momentary lapses where they forget which pedal is which. For some, this is just how they walk or drive, and they may just be directionally challenged or sleep deprived. For others, these behaviors can be a sign of cognitive impairment in the future.
Early Dementia and Problems with Navigation
Those in the early stages of dementia may have a harder time than cognitively healthy individuals when it comes to navigation, a new study that is published in the journal Current Biology suggests.
In the study, experts at University College London used virtual reality to determine that those with cognitive impairment have difficulty turning when walking. To conduct the study, scientists asked 43 people with mild cognitive impairment (a condition that can be a precursor to Alzheimer’s), 31 cognitively healthy adults in their 20s, and 33 cognitively healthy older adults to complete a walking test while wearing virtual reality glasses.
All three groups were asked to complete a task while wearing virtual reality glasses that allowed them to make real movements. The participants walked along a triangular route guided by numbered cones, consisting of two straight walks connected by a turn. They then had to return to their starting position guided by their memory alone.
The only participants who struggled to navigate turns along the path when conditions changed were those with cognitive impairment. These individuals consistently miscalculated how much to turn and experienced concerns when it came to their sense of direction while they walked. None of this happened with the other participants who were cognitively healthy.
Patterns Detected in Driving Were Also Found to Reveal Cognitive Decline
Another study looked at navigation in a different way, showing how subtle differences may emerge in how some people with cognitive impairment control a vehicle. These changes may also be associated with the early stages of Alzheimer’s disease.
In the DRIVES Study at Washington University, a group of people over age 65 in Missouri agreed to have their driving closely monitored for one year. Driving requires a skill known as path navigation, which requires the brain to automatically update its understanding of where the body is physically located in its environment based on its own movement. Cognitively healthy people constantly do this every day with ease, but it can be a real challenge for someone with cognitive impairment. Participants in the study with cognitive impairment were found to drive a lot more slowly, make abrupt changes and wide turns, travel less at night, and log fewer miles overall. They also visited a much smaller variety of destinations, sticking to confined routes. Using the results of the driving data, researchers were able to design a model that could forecast someone’s likelihood of developing further cognitive impairment using merely their age and their GPS driving data, and it proved to be 86 percent accurate.
“How people move within their daily environments, ranging from the places they visit to how they drive, can tell us a lot about their cognitive health,” says Sayeh Bayat, a PhD candidate at the University of Toronto, who led the study.
Both studies showed navigational challenges experienced by those with some cognitive impairment. Common findings from both studies included the following:
- Dementia tends to develop first toward the back and middle of the brain and then slowly spread forward. Spatial navigation depends on the parietal lobes of the brain, which are in the rear half of the brain and are in the region where the disease most often strikes first.
- Researchers found that individuals with early-stage dementia consistently overestimated the turns and showed increased variability in their sense of direction.
- A person without cognitive impairment can judge how far away something is by using a portion of their brain to process the spatial relationship between two items. We use this ability when we engage in activities such as driving. If someone begins to display a tendency for driving dangerously, part of the issue might be an inability to accurately judge how far away a given item is. This could be a sign that the brain is not working accurately in the area where spatial relationships are processed.
- The fact that people’s spatial and navigational behavior changes when they have dementia is well documented. The National Institute on Aging says family members may eventually notice that their loved one is taking longer to complete a simple trip, and when it comes to driving, has been driving more erratically or gets muddled over which pedal is which.
- Because the cognitively impaired all had some difficulty with navigation, among other things, the results suggest that navigational challenges seen in the tests are unique to cognitive impairment and not simply a normal result of aging.
- Studying the walking and driving habits of people with cognitive impairment could be a new way to diagnose dementia early.
- For both studies, researchers agree that larger studies for longer amounts of time need to occur.
Researchers believe that if more research confirms the findings, it may help scientists develop a test for early dementia based on specific aspects of navigation, according to a statement by lead walking study author Andrea Castegnaro, PhD, of the University College London Institute of Cognitive Neuroscience. She said, “We aim to develop practical tests that can be easily integrated into clinical settings, considering common constraints such as limited space and time. Traditional navigation tests often have requirements that are challenging to meet in a clinical environment. Our research focuses on specific aspects of navigation that are more adaptable to these constraints.”
What Can Be Done to Help Keep Navigational Skills Sharp
Research has shown that Alzheimer’s can start in the brain up to 20 years before symptoms show. Having an early indication of who is likely to develop the condition based on virtual reality or GPS testing can be factors that help doctors know when to prescribe treatments.
For those who want to keep their navigational abilities sharp, they can do so by using physical maps or landmarks to follow a route instead of simply relying on tools like Google maps. It is possible to mitigate some of the negative effects of Alzheimer’s by keeping the brain stimulated, including by using spatial abilities as much as possible. Actively stimulating navigational skills won’t significantly affect the trajectory of the disease but it may help people stay better oriented in navigating space for as long as possible.
If You or a Loved One Has Cognitive Impairment. . .
For those with cognitive impairment, you may be having problems with navigation and orientation, such as getting lost and not being able to follow directions. You may be looking straight at an object, such as a street sign, but you cannot identify it. You also may have difficulty walking up and down stairs because you are misjudging the height of the stairs or the distance between them. Aspects of your surroundings, such as noise and crowds, may start becoming more overwhelming and stressful.
Dementia can also affect your judgment. You may find it more difficult to do tasks that challenge your problem-solving abilities. You may find yourself getting frustrated trying to do things you used to be able to do with no issue, such as finding your way to once-familiar places.
Strategies to manage these changes include:
- Ask for help and rides from family and friends, if appropriate.
- Be realistic about your ability to drive (consult your doctor).
- Recognize what you can do and the limits to this.
- Strengthen your cognitive reserve by challenging your brain.
- Focus on activities that you can manage and enjoy.
- Eat well, exercise regularly, and stay socially active.
- Stay organized and have well-established daily activities.
Plan in Advance for Your Loved One with Dementia
Do you have a loved one with cognitive impairment or who has been diagnosed with Alzheimer’s or another form of dementia? The Farr Law Firm is dedicated to easing the financial and emotional burden on those suffering from all forms of dementia and their loved ones. We help protect your family’s assets while maintaining your loved one’s comfort, dignity, and quality of life by ensuring eligibility for critical government benefits such as Medicaid and Veterans Aid and Attendance. If you have a loved one who has been diagnosed with Alzheimer’s or another form of dementia, please call us to make an appointment:
Northern Virginia Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797
About Evan H Farr, CELA, CAP
