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March 3, 1989

Vision-Related Problems May Offer Clues for Earlier Diagnosis of Alzheimer's Disease

JAMA. 1989;261(9):1259. doi:10.1001/jama.1989.03420090023005

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ALZHEIMER'S DISEASE affects 2.5 million Americans, more than 7% of the American population aged over 65 years. Many of those affected have nonspecific visual complaints.

These may be expressed as losing one's place when reading, glare, misjudging distances, clumsiness, bumping into things, knocking things over, and tripping. When tested, the patients have normal visual acuity, but additional neuro-ophthalmologic tests may reveal abnormalities.

More Specific Tests  Such tests might include having the patient copy a line drawing, registering eye movements, photographing the fundus, and recording visual-evoked potentials (electrical activity over the occipital lobe, as it responds to retinal stimulation).Color vision and contrast sensitivity also may be assessed. Sometimes the standard adult tests need to be adapted as for pediatric patients, because the person with Alzheimer's disease may have trouble communicating.Thomas Bosley, MD, Wills Eye Hospital and the University of Pennsylvania, Philadelphia, and colleagues recently tested five persons with clinically