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A groundbreaking study led by researchers from the University of California San Francisco (UCSF) has identified a constellation of visuospatial symptoms as the initial signs of Alzheimer’s disease, distinct from traditional memory-related symptoms. The study, involving approximately 1,000 people with posterior cortical atrophy (PCA), revealed that these visuospatial symptoms occur in up to 10% of Alzheimer’s cases.
Posterior cortical atrophy (PCA) is strongly indicative of Alzheimer’s, with 94% of PCA patients showing Alzheimer’s pathology, according to the findings published in The Lancet Neurology. This form of atypical Alzheimer’s primarily manifests through visuospatial challenges, contrasting with memory-related issues commonly associated with Alzheimer’s disease.
Patients with PCA often struggle with judging distances, distinguishing between moving and stationary objects, and encountering difficulties in tasks like writing and retrieving dropped items, despite having normal eye exams. Unlike the typical cognitive decline seen in memory-related Alzheimer’s cases, PCA patients initially exhibit normal cognition. However, by the time of the first diagnostic visit (an average of 3.8 years after symptom onset), mild to moderate dementia becomes apparent, with deficits in memory, executive function, behavior, and speech and language.
At the time of diagnosis, specific visuospatial challenges were identified in PCA patients. Notably, 61% demonstrated “constructional dyspraxia,” an inability to copy or construct basic diagrams; 49% had a “space perception deficit,” difficulties identifying the location of seen objects; and 48% experienced “simultanagnosia,” an inability to visually perceive more than one object at a time. Additionally, challenges in basic math calculations (47%) and reading (43%) were observed.
Marianne Chapleau of the UCSF Department of Neurology emphasized the need for increased awareness of PCA among clinicians. Identifying PCA early in patients may lead to more effective treatment strategies. With an average age of symptom onset at 59, younger than typical Alzheimer’s symptoms, PCA patients are often less likely to be diagnosed promptly.
Early identification of PCA can be crucial for the timely initiation of Alzheimer’s treatments, providing potential benefits for patients facing visuospatial challenges associated with this form of the disease. Researchers highlighted the importance of developing better tools for clinicians to identify PCA early in clinical settings, emphasizing the need for increased awareness and improved diagnostic approaches.
