A clinical guide to assessment of navigation impairment: Standardized subjective and objective instruments and normative data

Abstract

Objective: Problems with finding one’s way around are frequently reported by neurological patients. However, no dedicated standardized tools exist to assess whether such reports indicate navigation impairment or not. We provide a standardized three-step method to assess navigation ability in neurological patients, based on two recently developed diagnostic tools and normative data. The objective of this method is to assess navigation ability in detail, to allow for appropriate rehabilitation training for navigation impairment. Method: A population-based sample of 7150 Dutch individuals (age 18–89) filled out the Wayfinding Questionnaire (WQ), to assess their self-reported navigation ability and level of spatial anxiety. Additionally, the participants completed the Leiden Navigation Test (LNT), a brief digital test consisting of five subtasks, assessing distinct domains of navigation ability. Both the WQ and LNT can be found online, free of charge. Results: Normative data stratified by gender and age are reported for each of the three subscales of the WQ, and for each of the five subtasks of the LNT. Conclusions: Based on performance data of a very large population-based sample of participants, navigation performance of neurological patients with specific navigation complaints can be assessed in three steps. First, we recommend to inquire about potential problems concerning navigation. Next, in case of navigation complaints, the extent of potential navigation impairment can first be measured with the WQ. Lastly, if impaired scores are found, the LNT can provide objective verification of the perceived impairment, as well as insight into which navigation domains are affected. Such insight will allow for prediction of the practical consequences of the impairment and can be used for informed and tailored rehabilitation.