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Clinical Manifestations.

Deepti Putcha1, Michael J Properzi2, Kathryn V Papp3

  • 1Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
PubMed
Summary
This summary is machine-generated.

Subjective cognitive decline, particularly visuospatial concerns, may indicate preclinical Alzheimer's disease (AD). The Everyday Cognition Scale (ECOG) shows promise in identifying individuals with early AD biomarkers.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Medical Diagnostics

Background:

  • Subjective Cognitive Decline (SCD) in cognitively unimpaired (CU) individuals signals increased Alzheimer's disease (AD) risk.
  • AD presents heterogeneously, including atypical Posterior Cortical Atrophy (PCA) variants.
  • Methods to detect preclinical PCA are currently lacking.

Purpose of the Study:

  • To investigate subjective visuospatial decline in CU individuals.
  • To explore associations between visuospatial concerns, cognitive performance, and AD biomarkers (amyloid and tau).

Main Methods:

  • Analysis of Everyday Cognition Scale (ECOG) visuospatial subscale responses from 253 CU participants.
  • Correlation with objective cognitive tests and amyloid PET (PiB) positivity.
  • Exploratory tau PET analysis to assess tau burden.

Main Results:

  • 4% of CU participants reported visuospatial difficulties.
  • Subjective visuospatial decline correlated with amyloid PET positivity (PiB+).
  • Visuospatial concerns linked to tau deposition in specific brain regions.

Conclusions:

  • Subjective visuospatial decline in CU individuals may reflect early AD pathology.
  • The ECOG tool can detect subtle visuospatial changes alongside memory concerns in preclinical AD.
  • Identifying atypical AD variants aids early diagnosis and treatment strategies.