Understanding Dementia: Posterior Cortical Atrophy

Posterior Cortical Atrophy (PCA) is a condition that is a variant of Alzheimer’s disease. It is marked with the same plaques and tangles but it begins in a different part of the brain. PCA, also known as Benson syndrome, affects areas in the back of the brain that are primarily responsible for complex visual processing, special perception, spelling and calculations. 

Some of the early symptoms of PCA would include blurred vision, difficulties reading and writing with non-visual aspects of language preserved, problems with depth perception, increased sensitivity to bright light—even shiny surfaces, possibly double vision and difficulty seeing clearly in low light conditions. The person could have trouble accurately reaching out to pick up an object. 

As the disorder progresses, other symptoms evolve such as getting lost while driving or walking in familiar places, misrecognition of familiar faces and objects, and, rarely, visual hallucinations. Calculation skills and the ability to make coordinated movements are affected in some cases. 

Some people with PCA will go to see an eye doctor first, thinking that they need new glasses because of the changes with their eyes. It’s important to understand that visual impairment usually develops as we get older; in most cases, due to the natural aging process, we have a decline in our vision usually after the age of 40. In people with PCA, the vision problem is not due to the natural aging process; rather, the shrinking brain can no longer interpret and process the information received from the person’s healthy eyes.

Typically, when first experiencing symptoms, the person is in their mid-fifties to mid-sixties. As PCA progresses, day-to-day memory, finding words and cognitive functions may become affected, which is typical of Alzheimer’s. In later progression, people may experience seizures and jerky movements in their limbs. The average life-span after onset of symptoms is 10-12 years, although some live longer.
There is no cure for PCA. However, some people can benefit from physical and occupational therapy. Medication for Alzheimer’s is what is normally prescribed and if the person is irritable or depressed, an anti-depressant is given. It’s recommended you weigh the pros and cons when deciding to take medication. 

–By Regina Posvar

Questions about dementia:

Q: I have noticed that one of my sisters is struggling with her memory. I have spoken to her about it and she is concerned too, but doesn’t do anything about it. I think she forgets to make an appointment with her doctor. Also, I think she is embarrassed. How can I help her push through to go? 

A: It is quite a challenge trying to get someone to the doctor for a check-up regarding memory because of the stigma attached to it. Encouraging your sister to check other health areas is an easier way to get her in. Most people do not go for routine check-ups, which should include brain health checks. This would help reduce the stigma. But this is not the norm, and people only go when something is wrong. By that time, it has festered into something more. When a person detects a symptom in their body, they usually ignore it unless it is annoyingly painful or unsightly. When it comes to memory or thinking concerns, it doesn’t hurt, nor can anyone see it. So it’s not as easy as one might think to get a person to see a doctor. Does she have something else that she needs to see a doctor about? There are other ways to phrase the issue such as relating brain health to checking vitamins and hormones, or making sure she is not deficient in any nutrient. You can offer to go with her for support, and even get your own brain health check-up as preventative for you and extra support for her. The key is to keep trying. Early detection and good support will improve her quality of life as the disease progresses. 

Regina Posvar is the current president of the Saint Lucia Alzheimer’s and Dementia Association and has been a licensed nurse for 25 years. SLADA is supported by volunteers and donations and aims to bring awareness and support by providing awareness public workshops, family support, memory screenings, the Memory Café, counselling and family training for coping skills and communication with persons living with dementia.