Posterior cortical atrophy: A seven-year single case study of neurocognition and adaptation

Objective: This paper describes the progression of the neurocognitive abilities and patient-centered adaptation strategies involved in different stages of Posterior Cortical Atrophy (PCA). Methods: The neurocognitive profile, functionality and adaptation strategies of a man (DG) who suffered from PCA are documented over 7 years. Results: DG experienced early and fast progressing visual attention and recognition difficulties (starting from alexia and evolving to prosopagnosia and object agnosia). He later developed visuo-spatial impairments and by the end of his illness, could no longer expressed himself verbally. Remarkably, his verbal comprehension, recognition and practical reasoning remained functional throughout most of his illness. DG wanted to remain intellectually and physically active over the course of his illness. Accordingly, his life activities were adapted based on his progressive decline while maximizing his functionality. In the early and middle stage of his illness, he acquired knowledge by listening to information (e.g., audio books) and went swimming. In the last stage, he engaged in speech therapy as oral communication became a priority, and in physiotherapy to maintain good posture and balance. Remarkably, DG always remained motivated to engage into meaningful activities. Conclusions: DG's case confirms that PCA has a progressive cognitive profile distinct from AD. It exemplifies PCA patients' engagement and illustrates the needs for adapting support offered though PCA stages. It is an important addition the knowledge about the longitudinal cognitive and behavioral manifestations in PCA and the possible adaptation strategies over its progressive stages.