SPACE: A novel digital tool for assessing hippocampal structural integrity in older adults

Hippocampal atrophy is a hallmark of Alzheimer’s disease and is linked to deficits in navigation. We investigated whether performance in a novel digital assessment, the Spatial Performance Assessment for Cognitive Evaluation (SPACE), is associated with hippocampal volume beyond traditional neuropsychological tests in older adults. Forty older adults (Mage = 67, SD = 6) 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. Regression analyses revealed that poorer performance in the path integration and mapping tasks was associated with smaller hippocampal volume after accounting for age, education, and neuropsychological test performance. Notably, individuals who accurately completed the path integration task and successfully learned the spatial configuration of landmarks required for subsequent reconstruction in the mapping task exhibited larger hippocampal volumes. Together, these findings suggest that SPACE may capture aspects of spatial cognition closely linked to hippocampal structural integrity and may complement existing cognitive assessments by providing increased sensitivity to hippocampal variation in non-clinical older adults.