Psychometric Investigation of the Novel Changes in Navigation Questionnaire (CNQ) in Typical Aging

Sara Pishdadian, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
Philip Chalmers, York University, Toronto, Canada
Susan Vandermorris, Baycrest Health Sciences, Toronto, Canada
Morris Moscovitch, University of Toronto, Toronto, Canada
Shayna Rosenbaum, York University, Toronto, Canada


A growing literature suggests that spatial navigation difficulties may be a uniquely sensitive and specific marker of Alzheimer’s disease (AD) in older adults. While subjective reports of cognitive abilities are ubiquitous in diagnosing AD, subjective spatial navigation abilities are typically not incorporated in assessments. Informed by research on subjective cognitive decline questionnaires in older adults, a novel 12-item questionnaire (10 Likert-scale and 2 open-ended items) on subjective changes in spatial navigation abilities, the Changes in Navigation Questionnaire (CNQ) was created with items divided along a hypothesized factor structure of typical and atypical age-related navigation changes. This study evaluated this new questionnaire’s psychometric properties in typical aging.

Participants and Methods:

An international sample of older adults (N = 533, 53% female, aged 60–80) was administered a demographic questionnaire and online tasks. Online tasks included 1. Spatial navigation questionnaires: CNQ, Santa Barbara Sense of Direction Questionnaire (Hegarty et al., 2002), Navigational Strategies Questionnaire (Brunec et al., 2018), and Wayfinding Questionnaire (van der Ham et al., 2013); 2. Subjective memory questionnaires: Multifactorial Memory Questionnaire (Troyer & Rich 2018) and Survey of Autobiographical Memory Episodic subscale (Palombo et al., 2013); 3. Objective memory tasks: Face-Name Task (Troyer et al., 2011) and Four Mountains Task (Burles et al., 2020); and 4. Psychological distress measures: GAD-7 and PHQ-9 (Spitzer et al., 1990).


After data cleaning and characterization of the sample on subjective and objective memory tasks, descriptive statistics, and Item Response Theory analyses were used to investigate the latent structure and internal reliability of the CNQ. As hypothesized, participants endorsed few navigation changes on the CNQ, and most endorsed changes were on the typical aging items. Responses on the measure’s open-ended questions indicated that most participants reported negative changes in their navigation ability, including reduced navigation confidence, greater reliance on technology when navigating, and avoiding navigation at night. Exploratory followed by confirmatory item factor analyses indicated that CNQ latent structure was best captured with a 2-factor model, with two items (reliance on others and technology for navigation) cross-loading under both factors. Sex differences were noted, with women reporting more changes on the CNQ and worse spatial navigation abilities on all questionnaires. Path analysis with all spatial navigation questionnaires showed different loadings for items based on the categories of current spatial navigation ability, strategy use, spatial anxiety, and changes in ability (i.e., the CNQ).


This first investigation of the Changes in Navigation Questionnaire’s psychometric properties in a typically aging sample largely support the measure’s factor structure and shows that the measure diverges, as predicted, from other questionnaires on spatial navigation abilities. Results also expand on past literature to indicate the types of spatial navigation changes that are most common in typical aging and highlight sex differences. Findings are relevant to clinicians wishing to quantitatively measure self-reported spatial navigation abilities in aging and provide data on base rates of spatial navigation changes in aging across sex, which can be used to document the nature and extent of spatial navigation difficulties.

Category: Aging

Keyword 1: self-report
Keyword 2: aging (normal)
Keyword 3: metamemory