Alzheimer's patients typically begin to show signs they have the disease via memory issues, but for some patients, an early warning sign arrives another way. Per the Washington Post, there's a rare variant of the condition, called posterior cortical atrophy, in which patients start having vision problems early on, though thousands of people go undiagnosed for years due to the atypical symptom presentation. Now, thanks to what's believed to be the first large-scale global research on PCA, there's hope for change on that front. In the new study published in the journal Lancet Neurology, researchers from UC San Francisco looked at the medical files of nearly 1,100 PCA patients from 16 nations, and one particularly interesting nugget emerged: Patients with PCA start exhibiting their unusual symptoms about five or six years before individuals with the more common form of Alzheimer's.
Those symptoms usually include trouble driving and reading, especially at night. The majority of patients—about 60%—are women, for unclear reasons. Still, even when these symptoms pop up, patients with PCA, on average, aren't diagnosed until about four years after those first signs, the researchers say. Individuals who start experiencing them don't suspect Alzheimer's, and so usually start first with their primary doctor, then head to different eye doctors, until they finally hit upon a visit with a neurologist. The study also found that, similar to patients with more common Alzheimer's, which is also incurable, PCA patients exhibited levels of amyloid and tau plaques in their brains.
It's not the first time that the eyes have been looked at as a possible portal into Alzheimer's diagnoses: Last fall, the Wall Street Journal reported on a company that says it can scan patients' eyes and then, using an artificial intelligence algorithm, pick up on signs of Alzheimer's, up to two decades before symptoms show up. "We thought it was really important to shed light on this syndrome [so] clinicians and researchers who conduct clinical trials can have a better sense of who these people are," Marianne Chapleau, one of the current study's lead authors, tells the Post.
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Currently, PCA patients are often excluded from those trials, because they're simply not on anyone's radar. For now, experts recommend that those with PCA displaying such vision issues head to occupational therapy, as well as implement lifestyle tweaks such as installing better lighting at home and reading large-print books. (What helped put PCA more into the public eye: one of its most famous patients, writer Terry Pratchett, who died in 2015.)