The impact of urban environment on spatial navigation in elderly people with mild cognitive impairment

Abstract Spatial cognition deficits are particularly prevalent in early stages of Alzheimer’s disease and in individuals with Mild Cognitive Impairment (MCI). Previous research using simplistic virtual reality (VR) settings was able to show such navigation impairments. However, the degree to which such results apply to more naturalistic environments remains unknown. Our study aims to test the hypothesis that spatial navigation in an elderly population with MCI could be improved by re-designing an urban space. Twenty-five MCI patients and a similar group of age- and gender-matched controls will be recruited to perform an urban spatial navigation VR task (uSNT). The uSNT is a modified version of the well-known virtual supermarket paradigm (designed to assess both egocentric and allocentric orientation processes), but the VR environment will be a real neighborhood of Lisbon. Specific interventions will be performed to various key parameters (street-level complexity, land-use, design, and green areas) and potential confounding elements (colors, textures, street occupation) of the urban scenario. Furthermore, eye tracking and electroencephalography data will be collected. Details of our task design and methodological approach to compare the navigation performance of both groups will be provided. In the future, we expect that the urban (re-)design interventions will positively impact on the navigation performance of MCI participants, being a clear proof-of-principle, that customize urban planning/design is key to enhance the autonomy and quality of life of such patients. Additionally, this research will establish the feasibility of replicating experimental conditions and ensuring consistency across different studies and subjects.