Predicting real-world navigation performance from a virtual navigation task in older adults

Virtual reality environments presented on tablets and smartphones offer a novel way of measuring navigation skill and predicting real-world navigation problems. The extent to which such virtual tests are effective at predicting navigation in older populations remains unclear. We compared the performance of 20 older participants (54-74 years old) in wayfinding tasks in a real-world environment in London, UK, and in similar tasks designed in a mobile app-based test of navigation (Sea Hero Quest). In a previous study with young participants (18-35 years old), we were able to predict navigation performance in real-world tasks in London and Paris using this mobile app. We find that for the older cohort, virtual navigation performance predicts real-world performance for medium difficulty, but not for the easy or difficult environments. While the younger sample outperformed the older sample in the virtual task, this was not the case in the real-world task, which conflicts with the dominant view of a decline in navigation ability with age. Self-reports identifying compensatory skills and further analysis of our participants' scores in the Montreal Cognitive Assessment and in the Navigation Strategy Questionnaire help give insights into the higher performance in the real world. Overall, our study supports the utility of using digital tests of spatial cognition in older age groups, while carefully adapting the task difficulty to the population.