Mr Naslund discusses practical applications to our recent article1 that described longitudinal changes in global, episodic, working memory, and visuospatial abilities. Of note, the first domain to change in individuals who were destined to develop Alzheimer disease (AD) was visuospatial ability, with decreased ability occurring up to 3 years before clinical diagnosis. The importance of this finding lies in the fact that in the evaluation for AD, episodic memory deficits are the domain most often looked at for diagnosis. These data indicate that AD affects all aspects of cognition and that visuospatial deficits develop early in the disease process. It seems likely that in some older adults who fall, this may be a consequence of visuospatial abnormalities caused by neurodegeneration.
Galvin JE, Johnson DK. Visuospatial Ability in Relation to Fall Risk and Dementia—Reply. Arch Neurol. 2010;67(5):643-644. doi:10.1001/archneurol.2010.72