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January 25, 2024 — A recent study suggests that alterations in visual perception may serve as an early warning sign of Alzheimer’s disease, particularly in women. While memory loss is commonly associated with Alzheimer’s, this research, published in the Lancet Neurology journal, reveals that individuals, especially women, may experience changes in visual perception abilities even before cognitive issues become apparent.
The study focused on nearly 1,100 people with posterior cortical atrophy (PCA), a condition involving the shrinkage of brain tissue in regions responsible for processing visual information. Although PCA often leads to problems with depth perception and reading, especially at night, cognitive abilities may initially appear normal.
Autopsies of the participants indicated that 94 percent of those with PCA had signs of Alzheimer’s disease, highlighting the close connection between PCA and Alzheimer’s.
Lead study author Marianne Chapleau, a neuropsychologist and postdoctoral fellow at the University of California, emphasizes that individuals with PCA may not recognize it as an early warning sign of Alzheimer’s, as visual symptoms often get attributed to aging eyesight.
“Visual symptoms in PCA may precede noticeable and broader cognitive issues associated with Alzheimer’s, because individuals often attribute visual problems to aging eyesight rather than connecting them to dementia,” says Dr. Chapleau. Consequently, an opportunity for earlier intervention may be missed.
Challenges in Recognition and Diagnosis
Participants in the study experienced difficulties in visual perception, including “constructional dyspraxia,” an inability to copy simple diagrams or figures, and trouble identifying locations or perceiving multiple objects at once. While these symptoms are typically addressed with optometrists and ophthalmologists initially, the underlying brain-related issue might not be recognized until later.
Dr. Andrew Budson, Chief of Cognitive Behavioral Neurology at VA Boston, notes that people often go through various eye-related consultations before being referred to a neurologist. Even at the neurology stage, further investigations may be needed, such as a magnetic resonance imaging (MRI) scan displaying brain shrinkage patterns consistent with PCA.
The Importance of Early Diagnosis
An early PCA diagnosis is crucial, as it offers opportunities for managing symptoms and slowing the progression of dementia. Anti-amyloid medicines like lecanemab (Leqembi) may be effective in slowing symptom progression.
Dr. Budson emphasizes the significance of lifestyle changes in promoting overall brain health. Adopting a healthy lifestyle with regular exercise, a balanced diet, and cognitive activities can contribute to well-being. Additionally, once diagnosed, managing symptoms and slowing dementia progression can be supported through interventions like cognitive therapies, medications, and individualized care plans.
While more research is needed to fully understand PCA, the study sheds light on the importance of recognizing visual changes as potential early indicators of Alzheimer’s disease, particularly in the context of PCA.
