Posterior Cortical Atrophy

Posterior Cortical Atrophy: Causes, Symptoms and Treatments

Posterior cortical atrophy is a health condition defined by the progressive degeneration of the brain’s outer layer (the cortex) in the back of the head. Unfortunately, little is known about this disease which makes it difficult to understand its prevalence. Some studies suggest that posterior cortical atrophy is present in about five percent of individuals with Alzheimer’s disease. Nonetheless, it is estimated that the true number could be closer to 15 percent.

What we do know is that posterior cortical atrophy tends to show in patients between the ages of 50 and 65 whereas Alzheimer’s disease generally presents in individuals 65 or older. Though researchers are working diligently to learn more about this disease, it is also vital that family members and friends understand what to expect from posterior cortical atrophy stages, what treatments are available, and how to access dementia care.

What Is Posterior Cortical Atrophy?

Posterior cortical atrophy is a rare form of dementia that involves the cortex in the posterior of the brain. More plainly, the disease affects the outer layer of the brain in the back of a person’s head. The posterior cortex, which processes visual cues from the world around us, gradually degenerates with this condition. As this area of the brain shrinks, individuals experience visual symptoms like difficulty judging distances and problems reading.

While posterior cortical atrophy often presents alongside Alzheimer’s disease, it is not yet understood if posterior cortical atrophy is a derivative of Alzheimer’s or a separate condition entirely. Underlying diseases may also contribute to posterior cortical atrophy. Lewy body dementia, for instance, is a condition in which people experience visual hallucinations and compromised mobility. Other diseases include corticobasal syndrome, a condition in which people have difficulty using one side of their body, and Prion disease, a very rare condition in which people experience a rapid decline in cognition.

Symptoms of Posterior Cortical Atrophy

Symptoms of posterior cortical atrophy vary depending on the person and the stage of progression. Nonetheless, there are some commonalities across the board. Most patients experience vision problems, which may have a slow onset and worsen over time. Individuals with posterior cortical atrophy will have difficulty with visual activities like:

  • Judging the distance between objects
  • Perceiving the difference between moving and stationary objects
  • Seeing multiple objects at once
  • Reading
  • Using or identifying common tools or objects

Some other possible symptoms include:

  • Anxiety
  • Hallucinations
  • Having trouble with spelling and math
  • Memory and cognitive problems in later stages

Posterior Cortical Atrophy Stages

Posterior cortical atrophy is a progressive condition, meaning it gets worse over time. There are currently no interventions to stop or slow the progression. However, understanding the seven stages of posterior cortical atrophy can help family members and friends better understand and anticipate cognitive decline.

  1. No cognitive decline. Behavior is normal. The individual does not experience any visual impairments or memory problems.
  2. Very mild cognitive decline. The individual will notice very subtle changes when completing complex visual tasks. For example, he or she may struggle to judge distances and, therefore, lose confidence as a driver.
  3. Mild cognitive decline. During this period, more subtle changes become noticeable to the individual as well as others. The person with posterior cortical atrophy will have difficulty finding and identifying objects, difficulty completing tasks that require spatial awareness, problems dealing with words and numbers, and mild memory problems. A doctor may be able to diagnose at this stage.
  4. Moderate cognitive decline. At this point, the individual will need assistance with everyday tasks. They may experience difficulty in navigating familiar and unfamiliar environments, even struggling to find the bathroom in their own home. They may lack the dexterity to use cutlery and may struggle to speak.
  5. Moderately severe cognitive decline. The individual’s vision will deteriorate so much so that the world now resembles a broken mirror. Many patients are registered as blind at this stage, and require support when walking and completing daily tasks. They may also experience headaches, hearing changes, feelings of instability, and involuntary movements.
  6. Severe cognitive decline. Though vision is the most pronounced impairment, individuals will now show typical symptoms of dementia such as changes in sleep patterns, trouble controlling their bladder or bowels, non-fluent speech, and inconsistent recollection of events.

Posterior Cortical Atrophy Causes and Risk Factors

More research is needed to better understand what causes posterior cortical atrophy. Researchers have yet to discover clear genetic mutations, risk factors, or causes connected to this condition. It is also unclear if it shares risk factors with other types of dementia; however, it is assumed that posterior cortical atrophy is connected to neurological conditions like Alzheimer’s disease or Lewy body dementia.

Posterior Cortical Atrophy Diagnosis and Treatment

Posterior cortical atrophy is commonly misdiagnosed because its symptoms vary and can be mistaken for different problems. Since symptoms are related to visual impairments, many individuals are misdiagnosed with eye problems when issues are actually related to the degeneration of brain tissue.

While diagnosing posterior cortical atrophy can be difficult, certain indicators distinguish the condition from others. Tell-tale signs include a gradual onset of vision impairments between the ages of 50 and 65. In the early stages, the patient will likely have no memory problems.

Researchers are working to develop a standard definition and diagnostic criteria for this disease. Currently, physicians use a combination of evaluation methods to make a diagnosis. Diagnostic tools may include:

  • Neuropsychological testing
  • Mental status testing
  • Neurological exams
  • Ophthalmology exams
  • Brain scans
  • Blood tests
  • Ruling out other causes of symptoms, such as stroke or tumor

Unfortunately, there are currently no treatments proven to cure or slow the progression of posterior cortical atrophy. However, doctors may still try to provide medications for symptom management. Since the condition can cause depression, frustration, and irritability, many patients benefit from antidepressants or anxiety medications. Cholinesterase inhibitors, a drug that prevents the normal breakdown of a key neurotransmitter, can also boost brain cell function to help make up for damaged tissue.

Various types of therapy can also be used to help someone affected by posterior cortical atrophy. Common therapies include:

  • Physical therapy
  • Cognitive therapy
  • Music therapy
  • Occupational therapy

Posterior Cortical Atrophy Care Options

Because posterior cortical atrophy is a progressive disease, the goal is to manage the condition and provide long-term care. Though medical professionals may prescribe medications and therapies to help improve quality of life, the individual will ultimately need assistance completing daily tasks like bathing, cooking, and cleaning. An assisted living and memory care community like The Brielle can provide much-needed support for individuals with posterior cortical atrophy.

Dementia Care at The Brielle

The Brielle is a nonprofit assisted living community on Staten Island that provides targeted care to those with posterior cortical atrophy. Understanding that this disease often exists in combination with Alzheimer’s disease or other neurological conditions, we provide support that focuses on the full diagnosis and the whole person.

Our goal is to provide the best quality of life possible for people who are experiencing cognitive decline. We offer superior assisted living and memory care options. Rather than simply focus on wellness support, we prioritize the physical, emotional, mental, and spiritual health of all residents.

To learn more about what The Brielle can offer your family, please reach out. You can contact us by phone or submit a request for more information online.


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