Spatial cognition as an early cognitive Marker for Alzheimer’s disease: evidence from NavegApp, an innovative serious game for cognitive assessment

Sep 30, 2026

Uploaded by Liam

Background: Limited access to diagnostic technologies in low and middle-income countries restricts early detection of Alzheimer’s Disease (AD). Digital neuropsychology advances enabled NavegApp, a serious game assessing allocentric navigation, mental rotation, and visuospatial memory—domains impacted in preclinical and prodromal AD. Prior usability and content validity support exists, but construct validity and diagnostic accuracy remain to be established. Objective: evaluate construct validity and diagnostic accuracy of NavegApp spatial cognition metrics across the AD spectrum. Method: retrospective observational study with 226 participants in five groups, including presymptomatic and symptomatic PSEN1-E280A carriers. Results: moderate associations with cognitive status, memory, and visuospatial domains; excellent discrimination for symptomatic carriers (AUC 0.94–0.97) but limited preclinical detection (AUC 0.66); acceptable accuracy for sporadic MCI (AUC 0.77).

LanguageEnglish

CategoryHealthcare

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DOI: 10. 1002/alz70856_104900 BIOMARKERS POSTER PRESENTATION BIOMARKERS (NON-NEUROIMAGING) Spatial cognition as an early cognitive Marker for Alzheimer’s disease: evidence from NavegApp, an innovative serious game for cognitive assessment Juan Pablo Sanchez1, 2 Diego Camilo Díaz3 Stella Maris Valencia4 David Fernando Aguillón Niño5 Mauricio Garcia-Barrera6 Daniel C. Aguirre-Acevedo7 Natalia Trujillo Orrego2, 8, 9 1 Grupo de Neurociencias de Antioquia, Facultad de Medicina, Universidad de Antioquia, Medellín, Antioquia, Colombia 2 University of Antioquia, Medellin, Colombia 3 Fundación Universitaria LuisAmigó, Medellín, Antioquia, Colombia 4 Grupo de investigación en salud mental, Universidad de Antioquia, Medellin, Antioquia, Colombia 5 Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia 6 University of Victoria, Victoria BC, Canada 7 Grupo de Neurociencias de Antioquia, Medellín, Antioquia, Colombia 8Atlantic Fellow for Equity in Brain Health at University of California, San Francisco / Trinity College of Dublin, San Francisco, CA, USA 9 Florida International University, Miami, FL, USA Correspondence Juan Pablo Sanchez, Grupo de Neurociencias de Antioquia, Facultad de Medicina, Universidad de Antioquia, Medellín, Antioquia, Colombia. [Email:](Email: juanp.sanchez@udea.edu.co)[ juanp.sanchez@udea.edu.co](Email: juanp.sanchez@udea.edu.co) Abstract Background: Limited access to diagnostic technologies in low and middle-income countries hinders the early detection of Alzheimer’s Disease (AD). Advances in digital neuropsychology have enabled the development of tools like NavegApp, a serious game-based platform that evaluates allocentric navigation, mental rotation, and visuospatial memory—domains affected during the preclinical and prodromal stages of AD. While previous studies have confirmed NavegApp’s usability and content validity, further evidence of its construct validity and diagnostic accuracy is required to support its potential implementation in primary care settings. The analysis of cognitive changes during these early disease stages, particularly in individuals carrying causative mutations for early-onset familial AD, is essential to advance the clinical utility of innovative digital cognitive markers. Therefore, the main objective of this study was to evaluate the construct validity and diagnostic accuracy of NavegApp’s spatial cognition metrics across theAD spectrum. Method: A retrospective observational study was conducted with 226 participants classified into five groups, including presymptomatic and symptomatic PSEN1-E280A carriers. Construct validity was assessed by examining correlations between NavegApp metrics and standard neuropsychological assessments. Group performance differences were analyzed using effect size estimates, controlling for sex, education, and age, while diagnostic accuracy was evaluated using ROC curve analysis. Result: NavegApp’s spatial cognition metrics demonstrated moderate associations with general cognitive status, memory, and visuospatial domains. Diagnostic accuracy analysis revealed excellent discriminative capacity for identifying symptomatic PSEN1-E280A carriers compared to asymptomatic participants, particularly in This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2025 The Alzheimer’s Association. Alzheimer’s & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer’s Association. Alzheimer’s Dement. 2025;21(Suppl. 2):e104900. [https://doi.org/10.1002/alz70856_104900](https://doi.org/10.1002/alz70856_104900) wi[leyonlinelibrary.com/journal/alz](leyonlinelibrary.com/journal/alz) 1of2 BIOMARKERS allocentric navigation (AUC-ROC = 0.94–0. 97). However, diagnostic performance for early preclinical detection was limited

FAQs

What problem does the study target regarding Alzheimer’s disease detection?

It addresses limited access to diagnostic technologies in low and middle-income countries, which hinders early detection of Alzheimer’s disease.

What does NavegApp assess, and which cognitive domains are measured?

NavegApp is a serious game evaluating allocentric navigation, mental rotation, and visuospatial memory, all of which are affected during preclinical and prodromal stages of AD.

How accurate is NavegApp for detecting different AD stages or groups?

It shows excellent discrimination for symptomatic PSEN1-E280A carriers versus asymptomatic participants (AUC 0.94–0.97), limited ability for early preclinical detection (AUC 0.66), and acceptable accuracy distinguishing sporadic MCI from healthy controls (AUC 0.77).

Sep 30, 2026

Uploaded by Liam