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Alzheimer's disease: a continuum with visual involvements.

Lorena Elvira-Hurtado1, Inés López-Cuenca1,2, Rosa de Hoz1,2,3

  • 1Ramon Castroviejo Institute for Ophthalmic Research, Complutense University of Madrid, Madrid, Spain.

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Summary

Visual function declines in early Alzheimer's disease (AD) stages, including mild cognitive impairment (MCI). Psychophysical tests can aid early AD diagnosis, even before significant memory loss.

Keywords:
Alzheimer’s diseasePDTcontrast sensitivityfamily historymild cognitive impairmentvisual acuityvisual function

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Area of Science:

  • Neuroscience
  • Ophthalmology
  • Gerontology

Background:

  • Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline.
  • Retinal structural changes are increasingly recognized as potential early indicators of AD pathology.
  • Visual function alterations often accompany structural retinal changes in AD patients.

Purpose of the Study:

  • To investigate visual function differences across various stages of Alzheimer's disease (AD) and related cognitive decline.
  • To compare visual function in individuals with a family history of AD (FH+), mild cognitive impairment (MCI), mild AD, and moderate AD against a healthy control group.

Main Methods:

  • Ophthalmological examination of 53 controls, 13 FH+, 23 MCI, 25 mild AD, and 21 moderate AD patients.
  • Assessment of visual acuity (VA), contrast sensitivity (CS), color perception, and visual integration.
  • Correlation of visual function tests with Mini Mental State Examination (MMSE) scores.

Main Results:

  • Statistically significant decreases in VA, CS, and visual integration were observed in MCI, mild AD, and moderate AD groups compared to controls.
  • Impaired CS at higher frequencies and color perception were noted in MCI, mild AD, and moderate AD groups versus FH+ and controls.
  • No significant visual function differences were found between the FH+ group and controls.

Conclusions:

  • Visual function deficits emerge in MCI and worsen with AD progression, remaining stable in mild to moderate stages.
  • Visual psychophysical tests serve as valuable, non-invasive tools for early AD diagnosis.
  • These tests complement neuropsychological assessments, aiding detection in preclinical and early AD stages.