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The earliest pathological accumulation of tau colocalizes with the areas of the MTL involved in object processing as part of a wider anterolateral network. Here, we sought to assess the diagnostic potential of memory for object locations in iVR environments in individuals at high risk of AD dementia (amnestic mild cognitive impairment [aMCI] <jats:italic>n<\/jats:italic>\u00a0=\u00a023) as compared to age\u2010related cognitive decline. Consistent with our primary hypothesis that early AD would be associated with impaired object location, aMCI patients exhibited impaired spatial feature binding. Compared to both older (<jats:italic>n<\/jats:italic>\u00a0=\u00a024) and younger (<jats:italic>n<\/jats:italic>\u00a0=\u00a053) controls, aMCI patients, recalled object locations with significantly less accuracy (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), with a trend toward an impaired identification of the object's correct context (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.05). Importantly, these findings were not explained by deficits in object recognition (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.6). These deficits differentiated aMCI from controls with greater accuracy (AUC\u00a0=\u00a00.89) than the standard neuropsychological tests. Within the aMCI group, 16 had CSF biomarkers indicative of their likely AD status (MCI+ <jats:italic>n<\/jats:italic>\u00a0=\u00a09 vs. MCI\u2212 <jats:italic>n<\/jats:italic>\u00a0=\u00a07). MCI+ showed lower accuracy in the object\u2010context association than MCI\u2212 (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.03) suggesting a selective deficit in object\u2010context binding postulated to be associated with anterior\u2010temporal areas. MRI volumetric analysis across healthy older participants and aMCI revealed that test performance positively correlates with lateral entorhinal cortex volumes (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) and hippocampus volumes (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01), consistent with their hypothesized role in binding contextual and spatial information with object identity. Our results indicate that tests relying on the anterolateral object processing stream, and in particular requiring successful binding of an object with spatial information, may aid detection of pre\u2010dementia AD due to the underlying early spread of tau pathology.<\/jats:p>","DOI":"10.1002\/hipo.23458","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T16:27:55Z","timestamp":1659457675000},"page":"660-678","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Assessing mild cognitive impairment using object\u2010location memory in immersive virtual environments"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1554-525X","authenticated-orcid":false,"given":"Andrea","family":"Castegnaro","sequence":"first","affiliation":[{"name":"Institute of Cognitive Neuroscience University College London  London 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