Validation of Spatial Orientation Screening questionnaire for use in memory clinic patients

Abstract

Background

Spatial orientation is required for independent mobility in society. Deficits in spatial orientation can be an early symptom of Alzheimer's disease and other dementias, and there is a need for brief assessment tools to identify impairments.

Objective

The aim of this study was to evaluate the construct and known-group validity of our newly developed Spatial Orientation Screening (SOS) questionnaire.

Methods

We included 132 patients with subjective cognitive decline (n = 16), mild cognitive impairment (n = 32), or all-cause dementia (n = 84) from a memory clinic and a reference group of cognitively unimpaired older adults (n = 108). The patients and their next-of-kin answered the self- and proxy-rated versions of the 4-item SOS (0–8 points) and the 10-item Questionnaire of Everyday Navigational Ability (QuENA, 0–30 points). The patients also performed the Floor Maze Test (FMT) for performance-based spatial abilities.

Results

Mean ages (SD) of the patient and reference groups were 68.6 (±7.6) years and 73.7 (±6.7) years, respectively. Construct validity between self-rated versions of the SOS and QuENA was satisfactory with r_s= 0.66, between the proxy-rated versions r_s= 0.61, and between the proxy-reported SOS and FMT r_s= 0.49 (all p < 0.001). Known-group validity was also acceptable, with significantly higher median (IQR) SOS self-reported scores in patients 1.0 (2.0) compared to the reference group 0.2 (0.5) points, (p < 0.001). Informants reported more severe impairments compared to the patients’ self-reports on both SOS and QuENA (both p < 0.001).

Conclusions

The SOS had satisfactory validity for use as a screening instrument for assessment of spatial orientation in memory clinic patients.