How Does Dementia Affect Visuospatial Abilities and Skills?

Learn How Dementia Affects Visual and Spatial Abilities

Visuospatial Changes in Dementia
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Dementia affects more than just the ability to remember things. It also can impact visuospatial abilities and skills.

What Are Visuospatial Abilities?

Also referred to as "visual-spatial" and "visuo-spatial," visuospatial abilities consists of the ability to understand what we see around us and interpret spatial relationships. In other words, this includes both the images we see (visual), as well as our perception of the size and location of our surroundings (spatial).

How Does Dementia Affect Visuospatial Abilities?

  • Depth Perception

Dementia can affect depth perception, making it more difficult to navigate tasks such as going down stairs and thus increasing the risk for falls. Activities of daily living such as getting into a bathtub, getting dressed or feeding oneself can also become more challenging.

Persons with dementia can also become easily lost and wander, even in very familiar environments. They might not recognize the path home that they've taken every day for many years, or be able to locate the bathroom in the middle of the night.

  • Recognizing Faces and Locating Objects

Visuospatial changes may also contribute, along with the cognitive symptoms of dementia, to the inability to recognize faces or find objects that are in plain sight.

  • Difficulty Driving

Driving may become more difficult as dementia develops, in part because of changes in the ability to understand spatial relationships.

For example, navigating a turn, changing lanes or parking a car could become a significant challenge due to a decline in visuospatial abilities. As dementia progresses, the difficult decision to quit driving usually must be made.

  • Reading

The ability to read may also decline, in part due to visuospatial changes, as well as a decline in ability to remember how to read or comprehend the meaning of the words.

Research on Visuospatial Ability and Other Kinds of Dementia

Visuospatial ability is affected in multiple types of dementia, including in the very early stages of Alzheimer's disease. Interestingly, several research studies have concluded that visuospatial changes are especially prevalent in Lewy body dementia, which includes dementia with Lewy bodies and Parkinson's disease dementia. One study noted that poor performance on visuospatial tests was connected with a faster rate of decline in persons with Lewy body dementia.

In addition, research demonstrated that visuospatial deficits have been correlated with an increase in hallucinations in Lewy body dementia. Hallucinations are one of the hallmarks of Lewy body dementia, making this connection with visuospatial ability intriguing and identifying it as an area for further research.

Visuospatial changes have also been regularly found in vascular dementia. Interestingly, visuospatial abilities appear to be less affected in behavioral variant frontotemporal dementia (also known as Pick's disease).

How Is Visuospatial Ability Measured in Dementia?

Certain cognitive tests include sections that help identify visuospatial impairments. These tasks include the clock drawing test, the task of drawing intersecting shapes (required on the MMSE) or copying a complex figure and the ability to recognize an object, such as a pencil or watch.

Additionally, the Visual Object and Space Perception (VOSP) test was designed to specifically assess visuospatial ability and can be helpful in identifying impairment in this area.

Sources:

American Journal of Geriatric Psychiatry. 2012 Sep;20(9):773-81. Early visuospatial deficits predict the occurrence of visual hallucinations in autopsy-confirmed dementia with Lewy bodies. www.ncbi.nlm.nih.gov/pubmed/21997600

Annals of Indian Academy of Neurology. 2014 Jan-Mar; 17(1): 12–18. Visuo-cognitive skill deficits in Alzheimer's disease and Lewy body disease: A comparative analysis. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992750/

Expert Review of Neurotherapeutics. 2011 Nov; 11(11): 1579–1591. Distinguishing Alzheimer's disease from other major forms of dementia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225285/

Neuropsychology. Nov 2008; 22(6): 729–737.Visuospatial Deficits Predict Rate of Cognitive Decline in Autopsy-Verified Dementia with Lewy Bodies.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2587484/

PLoS One. 2013; 8(7):  Visuospatial Function in Early Alzheimer’s Disease—The Use of the Visual Object and Space Perception (VOSP) Battery. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3713013/

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