Spatial navigation as a domain-specific marker of cognitive decline in down syndrome

The Department of Health and Human Services National Institutes of Health Office of the Director awarded $980,965 to Montclair State University on August 13, 2026, under the Trans-NIH Research Support program (CFDA 93.310) to conduct a project grant investigating spatial navigation as a domain-specific marker of cognitive decline in adults with Down syndrome.

The research will recruit 40 adults with Down syndrome ages 35–50 to examine whether and how spatial navigation impairments relate to cognitive decline in this population. In Aim 1, the investigator will administer established navigation tasks (including the Hidden Goal Task) to determine whether spatial navigation performance distinguishes adults with Down syndrome exhibiting early Alzheimer's disease-like decline from those experiencing normative aging, and to identify which types of navigation tasks focusing on egocentric and allocentric reference frames and switching between them are most sensitive to cognitive decline. In Aim 2, the research will assess whether spatial navigation uniquely predicts cognitive decline beyond executive function and will correlate laboratory-based navigation scores with informant-reported everyday navigation behaviors to establish the ecological validity of laboratory findings in real-life contexts.

Performance will take place in Montclair, New Jersey. The period of performance runs through July 31, 2029. This award is structured as a project grant, an assistance type subject to NIH peer review for scientific merit and program relevance.

Abstract

Adults with down syndrome (DS) face a disproportionately high risk for alzheimer's disease (ad), creating an urgent need for earlier detection and timely support. In neurotypical populations, spatial navigation deficits have emerged as sensitive and early markers of cognitive decline (e.g., in mild cognitive impairment [MCI] and ad). However, little is known about how these spatial deficits manifest in aging adults with DS. This study will address that GAP by examining whether, what, and how spatial navigation impairments relate to cognitive decline in DS. We will recruit 40 adults with DS (ages 35-50), a critical window in which mild cognitive changes may first appear yet could go undetected. In aim 1, we will administer well-established navigation tasks (e.g., the hidden goal task) to determine whether and to what extent spatial navigation performance distinguishes DS adults exhibiting early ad-like decline from those experiencing normative aging. We will also identify which types of navigation tasks-focusing on egocentric (body-centered) and allocentric (environment-centered) reference frames and the switching between the two-are most sensitive to cognitive decline. In aim 2, we will assess whether spatial navigation uniquely predicts cognitive decline beyond executive function (EF) and correlate laboratory-based navigation scores with informant-reported everyday navigation behaviors. This twofold approach will clarify if spatial tasks capture a domain-specific pathway to cognitive decline (beyond EF) and demonstrate their ecological validity in real-life contexts. Early recognition of cognitive decline in DS is crucial for timely intervention and adaptations to daily supports, yet few studies directly target spatial navigation in this population. By clarifying how egocentric, allocentric, and reference-frame-switching deficits manifest, establishing their predictive value beyond EF, and demonstrating their ecological validity, our study will pave the way for earlier, domain-specific detection of subtle cognitive decline in DS. Conducted under the R15 mechanism, this project will engage undergraduates in robust research experiences (e.g., neurocognitive testing, data analysis) within intellectual disabilities research. Ultimately, findings may inform refined screening protocols for DS and enhance our overall understanding of ad-related processes in other high-risk populations.