Spatial Memory Training and Cognitive Function

Hippocampal atrophy will be assessed by applying the SNIPE algorithm to T1-weighted structural MRI scans. The SNIPE score quantifies similarity of hippocampal image patches to those found in Alzheimer's disease (AD) patients and cognitively healthy controls, providing a continuous score ranging from -1 (AD-like) to +1 (control-like). Change in SNIPE score from baseline to post-treatment will be used to evaluate the effect of the intervention on neurodegeneration.

Changes in hippocampal volume as determined by structural magnetic resonance imaging (MRI).

Hippocampal atrophy will be assessed by applying the SNIPE algorithm to T1-weighted structural MRI scans. The SNIPE score quantifies similarity of hippocampal image patches to those found in Alzheimer's disease (AD) patients and cognitively healthy controls, providing a continuous score ranging from -1 (AD-like) to +1 (control-like). Change in SNIPE score from baseline to post-treatment will be used to evaluate the effect of the intervention on neurodegeneration.

Changes in spatial memory performance will be assessed according to the Functional Spatial Abilities Questionnaire (FSAQ), a 12-item self-report tool developed to assess spatial orientation and navigation abilities. Respondents rate their difficulty for a series of tasks. The total score, ranging from 12 to 36, is calculated by summing the individual item scores, with higher total scores indicating greater impairment in functional spatial abilities.

The 4-on-8 virtual maze is a computerized task which will be used to investigate spontaneous strategies used by participants. Participants have to find 4 hidden objects in an 8-arm radial-maze. Performance is measured in terms of errors committed.

Changes in spatial memory performance will be assessed according to the Concurrent Spatial Discrimination Learning Task (CSDLT). Participants complete a virtual reality program in which they are required to find a target object among a pair of arms presented simultaneously in a 12-arm radial maze. Performance is measured in terms of errors committed.

Participants are required to locate objects located in a virtual space. Performance is measured in terms of errors committed.

Rey Auditory Verbal Learning Task: participants are required to learn a list of 15 words via multiple trials, with immediate recall, delayed recall and recognition components.

Visual memory performance is evaluated according immediate and delayed recall in the Rey and Taylors complex figures tests (alternate versions used across visits).

General cognition is evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The battery, a standardized neuropsychological assessment used to evaluate cognitive functioning in adults, yields scores ranging from 40 to 160, with higher scores reflecting greater functioning.

Changes in general intelligence will be evaluated according to the Test of Nonverbal Intelligence, Third Edition (TONI-3), which is a standardized assessment designed to measure abstract reasoning and problem-solving abilities without relying on verbal communication or motor skills. The TONI-3 consists of 45 items, with a raw score range of 0 to 45, with higher scores reflecting greater intelligence.

Selective attention performance will be assessed according to the Stroop Neuropsychological Screening Test (adult version).

Changes in visual spatial motor performance will be assessed according to the Trail-making test of the D-KEF battery.

Changes in self-reported sense of direction will be ascertained according to the Santa Barbara Sense of Direction Scale (SBSDS), a 15-item self-report tool developed to assess navigational and spatial abilities. Respondents rate agreement for a series of spatial navigation related statements . The total score, ranging from 1 to 7, is calculated by summing the individual item scores and averageing them, with higher total scores indicating greater sense of direction.

Changes in self-reported sense of direction will be ascertained according to the Sense of Direction Questionnaire- Short-Form (SDQ-S), a 15-item self-report tool developed to assess awareness of orientation and memory for usual spatial behavior. Respondents rate agreement for a series of spatial navigation related statements. The total score, ranging from 17 to 75, is calculated by summing the individual item scores, with higher total scores indicating greater sense of direction.

Changes in self-reported well-being will be assessed according to the General Well Being Schedule, which includes positive and negative questions across six dimensions: well-being, self-control, vitality, depression, anxiety, and general health. Scores on this scale vary from 0 to 110, with higher scores representing better perceived well-being.

Changes in self-reported meta-memory will be evaluated according to the Multifactorial Memory Questionnaire Strategies (MMQ-Strategies), a 19-item tool developped to measures satisfaction with memory functioning, self-reported use of memory strategies, and self-appraisal of memory ability. The score, ranging from 0 to 76, is calculated by summing the individual item scores, with higher scores indicating greater use of memory strategies.

Changes in self-reported attention, memory, and cognition in everyday life will be measured according to the Cognitive Failures Questionnaire (CFQ), a 25-item self-report measure that assesses everyday cognitive failures or minor mistakes over the past 6 months. Respondents rate how often each mistake occurs. The score, ranging from 0 to 100, is calculated by summing the individual item scores, with higher scores indicating more cognitive failures.

Changes in self-reported quality of life will be determined according to the 36-Item Short Form Health Survey (SF-36), a self-report survey designed to assess mental and physical health impact on quality of life. The scale is divided in 6 subscales, physical functioning, physical limitation, emotional well-being and emotional limitations, energy/fatigue, social functioning, pain and general health. Each subscales ranges from 0 to 100, with higher score reflecting better quality of life.

Changes in perceived stress will be evaluated according to the Perceived Stress Scale, a 14-item scale that assess how different situations affect feelings and perceived stress. Respondents rate how often feelings and thoughts occurred during the last month. The scale ranges from 0 to 56 is calculated by summing the individual item scores, with a higher score indicating higher perceived stress.

Changes in mindfulness will be assessed according to the Five-Facet Mindfulness Questionnaire, a 39-item tool developed to assess an individual's mindfulness and self-awareness. Respondents rate statements about mindfulness. The overall score ranging from 39 to 195, is calculated by summing the individual item scores, with higher scores reflecting more mindfulness.

Changes in state-train anxiety will be ascertained according to the State-Trait Anxiety Inventory, a 40-item inventory developed to assess state and trait anxiety. Respondents rate state and trait statements about how they feel in the present moment and in general. The score, ranging from 40 to 160, is calculated by summing the individual item scores, with higher scores reflecting higher anxiety.

Changes in users' knowledge, usage, and opinions regarding GPS technology will be assessed using the Global Positioning System (GPS) questionnaire, a tool developped to assess GPS dependence and frequency of use. The total score ranging from 23 to 115 is calculated by summing the individual item scores, with higher total scores indicating greater GPS use.

Changes in activities in daily living will be assessed according to an abbreviated version of the DAD scale (disability assessment for dementia: DAD-6), an instrument for detection of loss of autonomy. Respondents answer questions related to activities of daily living. The score, ranging from 0 to 18, is calculated by summing the individual item scores, with higher scores indicating higher autonomy.

Changes in cognitive reserve level will be assessed according to the Cognitive Reserve Index Questionnaire, a questionnaire designed to measure an individual's capacity to compensate for susceptibility to cognitive impairment associated with age. The total score has a mean of 100 and a standard deviation of 15, with higher scores indicating more cognitive reserve.

Changes in physical activity level will be measured according to the Global Physical Activity Questionnaire, which was developed for assessing physical activity participation in three settings (Activity at work, Travel to and from places, and Recreational activities) as well as sedentary behavior. The score, ranging from 0 to 100, is calculated by averaging daily percentage of total physical activity, with higher scores indicating more physical activity.

Changes in cognition will be evaluated according to the Mini Mental State Exam scores, using 11 questions that assess five areas of cognitive function: orientation, registration, attention and calculation, recall, and language. The score, ranging from 0 to 30, is calculated by summing the individual item scores, with higher scores indicating less cognitive impairment.

Changes in cognition according to the Montreal Cognitive Assessment (MoCA) scale, a screening tool used to assess mild cognitive impairment. Respondents are evaluated on various cognitive domains, including attention, memory, language, and executive functions. The score, ranging from 0 to 30, is calculated by summing the sections scores, where a score of 26 or above is considered normal.

Changes in autobiographical memory will be assessed according to the Survey of Autobiographical Memory, a 26-item self-report tool developed to assess autobiographical memory capacities. Respondents rate statements about their autobiographical memory. The scale ranging from 26 to 130 is calculated by summing the individual item scores, with higher scores reflecting better autobiographical memory.

Changes in verbal fluency performance will be assessed according to the D-KEFs verbal fluency test.

Changes in quality of life level will be assessed according to the Quality of life scale (long version), a tool developed to assess quality of life. The scale, ranging from 0 to 100, is calculated by summing the individual item scores, with higher scores representing better quality of life.

Changes in self-reported memory ability will be assessed according to the Self-Report Memory Scale (Memory Assessment Clinics Self-Rating Scale), a 42-item self-report scale that assesses the ability to remember. Respondents rate statement about their ability to remember. The scale, ranging from 42 to 210, is calculated by summing the individual item scores, with higher scores reflecting better ability to remember.

Changes in self-reported memory complaint will be assessed according to the Auto-administered memory questionnaire, a 64-item french scale developed to assess memory complaints. The scale, ranging from 64 to 384, is calculated by summing the individual item scores, with higher scores reflecting greater subjective memory complaints.

Changes in self-esteem will be measured according the Rosenberg Self-Esteem Questionnaire, a 10-item scale developed to assess self-esteem. The scale, ranging from 10 to 40, is calculated by summing the individual item scores, with higher scores reflecting higher self-esteem.

Changes in impulsivity will be measured according to the Barrat Impulsivity Scale, a 30-item scale developed to assess impulsivity. The scale, ranging from 30 to 120, is calculated by summing the individual item scores, with higher scores reflecting higher impulsivity.

Changes in self-reported memory scores for all questionnaires metionned above will be compared across groups.

Changes in inhibitory control will be assessed according to the go-no-go test.

Changes in daily life aspects will be assessed according to the Spatial Memory Training Program(SMTP) Subjective Interview Questionnaire, an in-house self-report questionnaire designed to measure subjective memory changes, mood changes as well as any other subjective changes that the participant experienced since the beginning of the training. The scale, ranging from 12 to 58, is calculated by summing the individual item scores, with higher scores representing more positive changes.