Vestibular loss predicts poorer spatial cognition in patients with Alzheimer's disease

Eric X. Wei, Esther S. Oh, Aisha Harun, Matthew Ehrenburg, Yuri Agrawal

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


The vestibular system is an important contributor to balance control, spatial orientation, and falls risk. Recent evidence has shown that Alzheimer's disease (AD) patients have a higher prevalence of vestibular impairment relative to healthy controls. We sought to evaluate whether vestibular loss is specifically associated with poor spatial cognitive skills among patients with mild cognitive impairment (MCI) and AD. We enrolled 50 patients (22 MCI and 28 AD) from an interdisciplinary Memory Clinic and measured vestibular physiologic function in all patients. Spatial cognitive function was assessed using the Money Road Map Test (MRMT) and the Trail Making Test Part B (TMT-B). General cognitive function was assessed with the Mini-Mental Status Examination (MMSE). In multivariable linear regression analyses adjusted for age, gender, education level, and MMSE, MCI and AD patients with vestibular loss made significantly more errors on the MRMT relative to patients with normal vestibular function (β = 7.3, 95% CI 2.4, 12.1 for unilateral vestibular loss and β = 6.4, 95% CI 1.9, 10.9 for bilateral vestibular loss).We further stratified AD patients into "spatially normal" and "spatially impaired" groups based on MRMT performance, and found that the prevalence of vestibular loss was significantly higher in the spatially impaired AD group relative to the spatially normal AD group. These findings support the hypothesis that vestibular loss contributes specifically to a decline in spatial cognitive ability in MCI and AD patients, independently of general cognitive decline, and may predict a "spatially impaired" subtype of AD.

Original languageEnglish (US)
Pages (from-to)995-1003
Number of pages9
JournalJournal of Alzheimer's Disease
Issue number3
StatePublished - 2018


  • Alzheimer's disease
  • Money Road Map Test
  • Spatial cognition
  • Vestibular system

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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