It started with unusual coordination difficulties. For example, Charlie had difficulty opening an envelope. His wife Susan realized something was wrong and sent him to the doctor. But neither an eye specialist nor an optician made the correct diagnosis. It wasn’t until years later that Charlie was diagnosed with Alzheimer’s.
Researchers from the University of California San Francisco (UCSF) report on the case. Charlie is one of her patients. In a large-scale study, together with an international team of researchers, they have now examined the extent to which “bizarre visual-spatial symptoms” are an early warning sign of Alzheimer’s.
For the study, they used data from more than 1,000 patients from 16 countries. It was published on January 22, 2024 in the journal Lancet Neurology.
Visual processing difficult – this is how PCA manifests itself
Alzheimer’s patients are known to have cognitive difficulties. They also rarely have problems with visual-spatial coordination. The medical term for this is posterior cortical Atrophy (PCA, also Benson syndrome). According to the researchers, around ten percent of Alzheimer’s patients are affected.
PCA results in complex visual processing dysfunctions. “Patients with PCA have difficulty estimating distances or distinguishing between moving and stationary objects,” explains Marianne Chapleau, neurologist and co-author of the study. Writing or picking up fallen objects also becomes difficult for those affected. The problem: “Eye examinations often remain unremarkable.”
PCA as an early warning sign of Alzheimer’s disease
In their study, they wanted to find out whether and to what extent visual-spatial coordination problems could also be an early warning sign of Alzheimer’s.
They found that PCA “overwhelmingly predicts Alzheimer’s disease,” according to a press release accompanying the study. About 94 percent of patients with PCA also had Alzheimer’s. For comparison: among people with memory problems it was only 70 percent.
In addition, most patients did not have any Alzheimer’s-specific problems when PCS symptoms first appeared. It was only an average of 3.8 years later that mild to moderate dementia with cognitive difficulties was diagnosed.
That’s why an early Alzheimer’s diagnosis is so important
“We need greater awareness of PCA so that it is recognized by physicians,” Chapleau emphasizes. So far, this has often not been the case, especially among opticians and ophthalmologists. She demands: “We need better tools in the clinical environment in order to be able to identify and treat these patients at an early stage.”
An early diagnosis of Alzheimer’s is extremely important. Although there is currently no cure, individual symptoms can be treated and the progression of the disease slowed down with the help of medication.
“Early sensitization to early symptoms is becoming increasingly important, especially with regard to the new Alzheimer’s drugs, because the new antibodies are particularly effective in the early stages of the disease,” explains Frank Erbguth, President of the German Brain Foundation. Prevention measures are also more effective the earlier and more regularly they are implemented.
Alzheimer’s – these preventive measures exist
To date, not all causes of Alzheimer’s have been fully understood. It is also not yet known why some people get it and others don’t. In other words: Alzheimer’s can affect anyone.
However, there are certain risk factors that increase the likelihood of developing Alzheimer’s. Some of these risk factors are unavoidable, such as age or genetics. Others can be prevented or reversed through preventive measures.
The following are considered classic Alzheimer’s dementia prevention measures:
Healthy, balanced diet: A Mediterranean diet in particular appears to protect against Alzheimer’s and other forms of dementia. Lots of fruit, vegetables, fish, olive oil and whole grain bread should therefore be on the menu. Pork and dairy products such as fatty cheese and butter, on the other hand, should only be eaten in moderation.
Regular exercise: In order to protect against disease, the World Health Organization (WHO) recommends moderate (= slightly increased heart rate) physical activity of around 150 minutes a week, i.e. around 2.5 hours, for adults. People over 65 should also incorporate more exercises that promote balance, coordination and strength.
Mental activity: Anyone who is mentally active can improve the performance of their brain. By stimulating the nerve cells, they can network better and the connections can strengthen better. One also speaks of improved plasticity of the brain or expansion of the “cognitive reserve”. Contrary to popular belief, crossword puzzles do not help because they only test knowledge that is already known. It is better to be active and do or learn things that interest you and bring you joy, including listening to or making music, reading books or newspapers, playing card or board games or learning something new such as a foreign language or a sport. The following applies: the more complex the activity, the more stimulating it is for the brain.
Maintain social contacts: Loneliness can make you sick. Studies show that people who are unintentionally alone a lot have up to twice the risk of developing Alzheimer’s. It is therefore important to maintain social contacts or build up a network of contacts, for example through volunteer work, involvement in a sports club and choir, or a group trip.
By the way, you shouldn’t wait until the first symptoms appear. “A lifestyle with enough exercise, a healthy diet and enough sleep can reduce the risk of dementia by up to 30 percent and also protects against other diseases,” emphasizes Erbguth.