Visual-spatial deficits expalin visual symptoms in Alzheimer's disease.

PURPOSE To determine whether the visual symptoms of patients with Alzheimer's disease are related to visual-spatial dysfunction. METHODS We administered a test battery modified from existing neuropsychometric materials that taxed visual-spatial skills, form identification, color vision, and visual memory. We tested 14 patients with Alzheimer's disease who had visual symptoms prominent enough to prompt ophthalmologic consultation, 11 patients with Alzheimer's disease who lacked such visual symptoms, and a control group of 53 subjects without Alzheimer's disease. The groups with Alzheimer's disease were matched for Wechsler Adult Intelligence Scale-Revised scores. RESULTS Patients with Alzheimer's disease who had prominent visual symptoms differed significantly from those without prominent visual symptoms only in their relatively poor visual-spatial test scores. CONCLUSIONS Visual symptoms in Alzheimer's disease are related primarily to visual-spatial deficits. These findings are consistent with previous evidence that patients with Alzheimer's disease who have prominent visual symptoms have accentuated histologic and metabolic abnormalities in the parieto-occipital regions known to process visual-spatial information. The findings support the view that pathways mediating visual-spatial and form identification are at least partially segregated in the brain, and emphasize that tests used to screen visually symptomatic patients with Alzheimer's disease will be more effective if they prominently assess visual-spatial skills.