Effects of Route Complexity and Lighting on Route Following in Alzheimer’s Disease and Posterior Cortical Atrophy

Objective: Visual processing deficits arising in dementia are associated with particular functional disability. This study aimed to investigate the effects of the built environment on mobility and navigation in people with dementia-related visual loss. Methods: Participants with posterior cortical a...

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Main Authors: Amelia M. Carton, Chris Frost, Teresa Poole, Biao Yang, Ian D. McCarthy, Tatsuto Suzuki, Catherine Holloway, Robin Serougne, Derrick Boampong, Mary Pat Sullivan, Nick Tyler, Sebastian Crutch, Keir X. X. Yong
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/14/12/1217
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author Amelia M. Carton
Chris Frost
Teresa Poole
Biao Yang
Ian D. McCarthy
Tatsuto Suzuki
Catherine Holloway
Robin Serougne
Derrick Boampong
Mary Pat Sullivan
Nick Tyler
Sebastian Crutch
Keir X. X. Yong
author_facet Amelia M. Carton
Chris Frost
Teresa Poole
Biao Yang
Ian D. McCarthy
Tatsuto Suzuki
Catherine Holloway
Robin Serougne
Derrick Boampong
Mary Pat Sullivan
Nick Tyler
Sebastian Crutch
Keir X. X. Yong
author_sort Amelia M. Carton
collection DOAJ
description Objective: Visual processing deficits arising in dementia are associated with particular functional disability. This study aimed to investigate the effects of the built environment on mobility and navigation in people with dementia-related visual loss. Methods: Participants with posterior cortical atrophy (PCA; “visual-variant Alzheimer’s”; n = 11), typical Alzheimer’s disease (tAD; N = 10), and controls (n = 13) repeatedly walked down routes within a simplified real-world setting. Participant groups were of comparable age and gender. Routes were of different complexity (straight, U-shaped, and S-shaped), overhead lighting levels (low and high) and with or without a dynamic LED (light-emitting diode) cue (trial n = 24). Ratios of walking times for each experimental condition (each complex route vs the straight route, high lighting vs low, and LED cue vs no cue) were compared between participant groups. Kinematic measures were produced from a total of 10,813 steps using wearable inertial measurement units (IMUs). Results: The walking time ratios relating to route complexity were higher in the PCA group than in controls: 30.3% (95% CI [13.5%, 49.5%] higher for U-shaped vs straight and 31.9% [21.1%, 55.3%] for S-shaped vs straight, averaged over other conditions). The analogous results relating to route complexity for the tAD group were intermediate between those for the PCA and control groups. There was no evidence that walking time ratios differed according to lighting level or the presence of the LED cue. Conclusions: Findings contribute to evidence-based design for dementia-friendly environments, emphasizing consequences of environmental complexity for functional independence and mobility in people with dementia-related visual loss. Findings inform recommendations for environmental design to support the independence of individuals with dementia.
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spelling doaj-art-12b19a10f66d432094c3b9352c1803a12024-12-27T14:14:48ZengMDPI AGBrain Sciences2076-34252024-11-011412121710.3390/brainsci14121217Effects of Route Complexity and Lighting on Route Following in Alzheimer’s Disease and Posterior Cortical AtrophyAmelia M. Carton0Chris Frost1Teresa Poole2Biao Yang3Ian D. McCarthy4Tatsuto Suzuki5Catherine Holloway6Robin Serougne7Derrick Boampong8Mary Pat Sullivan9Nick Tyler10Sebastian Crutch11Keir X. X. Yong12Dementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UKDepartment of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UKDepartment of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UKPedestrian Accessibility Movement Environment Laboratory, Department of Civil, Environmental and Geomatic Engineering, University College London, London WC1E 6BT, UKPedestrian Accessibility Movement Environment Laboratory, Department of Civil, Environmental and Geomatic Engineering, University College London, London WC1E 6BT, UKPedestrian Accessibility Movement Environment Laboratory, Department of Civil, Environmental and Geomatic Engineering, University College London, London WC1E 6BT, UKPedestrian Accessibility Movement Environment Laboratory, Department of Civil, Environmental and Geomatic Engineering, University College London, London WC1E 6BT, UKPedestrian Accessibility Movement Environment Laboratory, Department of Civil, Environmental and Geomatic Engineering, University College London, London WC1E 6BT, UKPedestrian Accessibility Movement Environment Laboratory, Department of Civil, Environmental and Geomatic Engineering, University College London, London WC1E 6BT, UKFaculty of Education and Professional Studies, Nipissing University, North Bay, ON P1B 8L7, CanadaPedestrian Accessibility Movement Environment Laboratory, Department of Civil, Environmental and Geomatic Engineering, University College London, London WC1E 6BT, UKDementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UKDementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UKObjective: Visual processing deficits arising in dementia are associated with particular functional disability. This study aimed to investigate the effects of the built environment on mobility and navigation in people with dementia-related visual loss. Methods: Participants with posterior cortical atrophy (PCA; “visual-variant Alzheimer’s”; n = 11), typical Alzheimer’s disease (tAD; N = 10), and controls (n = 13) repeatedly walked down routes within a simplified real-world setting. Participant groups were of comparable age and gender. Routes were of different complexity (straight, U-shaped, and S-shaped), overhead lighting levels (low and high) and with or without a dynamic LED (light-emitting diode) cue (trial n = 24). Ratios of walking times for each experimental condition (each complex route vs the straight route, high lighting vs low, and LED cue vs no cue) were compared between participant groups. Kinematic measures were produced from a total of 10,813 steps using wearable inertial measurement units (IMUs). Results: The walking time ratios relating to route complexity were higher in the PCA group than in controls: 30.3% (95% CI [13.5%, 49.5%] higher for U-shaped vs straight and 31.9% [21.1%, 55.3%] for S-shaped vs straight, averaged over other conditions). The analogous results relating to route complexity for the tAD group were intermediate between those for the PCA and control groups. There was no evidence that walking time ratios differed according to lighting level or the presence of the LED cue. Conclusions: Findings contribute to evidence-based design for dementia-friendly environments, emphasizing consequences of environmental complexity for functional independence and mobility in people with dementia-related visual loss. Findings inform recommendations for environmental design to support the independence of individuals with dementia.https://www.mdpi.com/2076-3425/14/12/1217Alzheimer’s diseasebuilt environmentdementiaaccessibilityinertial measurement unitsnavigation
spellingShingle Amelia M. Carton
Chris Frost
Teresa Poole
Biao Yang
Ian D. McCarthy
Tatsuto Suzuki
Catherine Holloway
Robin Serougne
Derrick Boampong
Mary Pat Sullivan
Nick Tyler
Sebastian Crutch
Keir X. X. Yong
Effects of Route Complexity and Lighting on Route Following in Alzheimer’s Disease and Posterior Cortical Atrophy
Brain Sciences
Alzheimer’s disease
built environment
dementia
accessibility
inertial measurement units
navigation
title Effects of Route Complexity and Lighting on Route Following in Alzheimer’s Disease and Posterior Cortical Atrophy
title_full Effects of Route Complexity and Lighting on Route Following in Alzheimer’s Disease and Posterior Cortical Atrophy
title_fullStr Effects of Route Complexity and Lighting on Route Following in Alzheimer’s Disease and Posterior Cortical Atrophy
title_full_unstemmed Effects of Route Complexity and Lighting on Route Following in Alzheimer’s Disease and Posterior Cortical Atrophy
title_short Effects of Route Complexity and Lighting on Route Following in Alzheimer’s Disease and Posterior Cortical Atrophy
title_sort effects of route complexity and lighting on route following in alzheimer s disease and posterior cortical atrophy
topic Alzheimer’s disease
built environment
dementia
accessibility
inertial measurement units
navigation
url https://www.mdpi.com/2076-3425/14/12/1217
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