SPACE: A Novel Digital Tool for Assessing Hippocampal Structural Integrity in Older Adults

Hippocampal atrophy is a hallmark of Alzheimer’s disease and is associated with deficits in navigation. We investigated whether a novel digital assessment, the Spatial Performance Assessment for Cognitive Evaluation (SPACE), can predict hippocampal integrity beyond traditional neuropsychological tests in older adults. Forty older male participants underwent structural MRI and completed the spatial and navigation tasks in SPACE along with a battery of neuropsychological tests typically used to detect cognitive impairment. A regression model revealed that worse performance in the path integration and mapping tasks significantly predicted smaller hippocampal volume above age, education and all neuropsychological tests. Critically, participants who successfully learned the positions of landmarks in a virtual environment during a path integration task and accurately reproduced the configuration in a mapping task had larger hippocampal volumes. These findings indicate that SPACE can serve as a valuable addition to traditional cognitive assessments by providing greater sensitivity for assessing hippocampal volume.