Association among visual associations, visual acuity, and specific eye pathologies in Alzheimer's disease: treatment implications

Royal Victoria Infirmary, Newcastle, United Kingdom.
American Journal of Psychiatry (Impact Factor: 12.3). 01/2000; 156(12):1983-5.
Source: PubMed


Studies suggest a link between visual acuity and visual hallucinations in dementia, but links with specific eye pathologies have not been evaluated.
Fifty patients (20 with visual hallucinations, 30 without) with probable Alzheimer's disease had an evaluation of psychotic symptoms. Visual acuity was measured before and after refractions, and ophthalmological examinations included standardized assessments for cataracts and macular degeneration.
Impaired visual acuity and the severity of cognitive impairments were significantly associated with visual hallucinations. No patients with normal acuity (6/5 or 6/6 on the Snellen chart) experienced these symptoms. Impaired acuity improved with refraction in 60% (N = 12) of the patients with visual hallucinations. Of specific eye pathologies, only cataracts were significantly associated with visual hallucinations. Descriptive follow-up information suggests that an optician's assessment for glasses improves outcome.
Glasses and cataract surgery need evaluation as prophylactic or adjunctive treatments for visual hallucinations in patients with probable Alzheimer's disease.

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    • "The identification of the various contributing factors can be difficult because the symptoms frequently overlap or coexist and they may also respond to similar treatment modalities (Ballard et al, 2011). Physical health problems such as infection, pain, and dehydration are common in people with dementia and can often precipitate BPSD, as can visual and auditory impairment (Chapman et al, 1999). An association between pain and increased BPSD has been suggested (Husebo et al, 2013). "

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    • "; (5) Wilson et al. (2000); (6) Holroyd et al. (2000); (7) Chapman et al. (1999); (8) Ballard et al. (1999); (9) Barber et al. (1999); (10) Imamura et al. (1999); (11) Goetz et al. (1998a; 1998b); (12) Murgatroyd & Prettyman (2001); (13) Brown & Murphy (1992); (14) Holroyd et al. (1992); (15) Ballard et al. 1995a; (16) Mori et al. (2000); (17) Wesnes et al. (2001); (18) Diederich et al. (1998); (19) Holroyd & Sheldon-Keller (1995); (20) Ohayon et al. (1996); (21) Ohayon (2000); (22) Ostling & Skoog (2002); (23) Pliskin et al. (1996); (24) Howard et al. (1994); (25) Morrison et al. (2002); (26) Menon et al. (2003); (27) O'Reilly & Chamberlaine (1996); (28) Shiraishi et al. (2004); (29) Teunisse et al. (1998, 1999); (30) Scott et al. (2001); (31) Teunisse et al. (1995). DWB, dementia with Lewy bodies; AD, Alzheimer's disease; MMSE, Mini Mental Status Examination; CDR, cognitive drug research. "
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