Visual variant (posterior cortical atrophy) Alzheimer dementia

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- Visual perception is compromised in absence of any ophthalmological problem (Salardini 2019)

- Typically presents in mid-50’s or early 60’s (Crutch et al, 2017)

- Core cognitive symptoms should include at least 3 of the following (symptoms listed in order of frequency): (Crutch et al, 2017)

  • Space perception deficit
  • Simultanagnosia
  • Object perception deficit
  • Constructional dyspraxia
  • Environmental agnosia
  • Oculomotor apraxia
  • Dressing apraxia
  • Optic ataxia
  • Alexia
  • Left/right disorientation
  • Acalculia
  • Limb apraxia (not limb-kinetic)
  • Apperceptive prosopagnosia
  • Agraphia
  • Homonymous visual field defect
  • Finger agnosia

- Relative sparing of episodic memory, nonvisual language function, executive function, and behavior / personality in early disease (Crutch et al, 2017; Salardini 2019)

- Neuroimaging demonstrates occipito-parietal or occipito-temporal atrophy on MRI (or hypometabolism / hypoperfusion on FDG-PET or SPECT) (Crutch et al, 2017)


References

Crutch, S. J. et al. Consensus classification of posterior cortical atrophy. Alzheimers Dement. J. Alzheimers Assoc. 13, 870–884 (2017). https://pubmed.ncbi.nlm.nih.gov/28259709/

Salardini, A. An Overview of Primary Dementias as Clinicopathological Entities. Semin. Neurol. 39, 153–166 (2019). https://pubmed.ncbi.nlm.nih.gov/30925609/