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Alzheimer's Association International Conference 2026

July 12-15, 2026 | London, United Kingdom, and Online

5246

Predicting Visuospatial Decline In Alzheimer's Disease Based On Atrophy Patterns

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Poster Presenter

Grace Burt

Authors

Grace Burt, Sheena Baratono

Affiliations

Brigham and Women's Hospital; Center for Brain Circuit Therapeutics; Harvard Medical School, 1Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston, MA, USA. 2Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.. 3Center for Brain/Mind Medicine, Brigham and Women’s Hospital, Boston, MA, USA. 4Department of Cognitive and Behavioral Neurology, Brigham and Women’s Hospital, Boston, MA, USA

Part of Topic

Functional decline and lack of independence in Alzheimer’s Disease (AD) are frequently attributed to global disease burden or memory impairment1,2.

•AD is highly heterogeneous1, and visuospatial dysfunction may more specifically drive this loss of independence.

•Early intervention has shown that visuospatial deficits are potentially modifiable2,3, yet their structural correlates remain under-utilized in prognosis4.

•

This study investigates the predictive value of a visuospatial-specific atrophy profile compared to standard markers of disease burden and memory loss in determining patient outcomes.

Using Alzheimer’s Disease Neuroimaging Initiative ADNI2 data (n = 139), we mapped atrophy patterns causing deficits in visuospatial construction (VS) and verbal memory (MEM). These maps were then spatially correlated with individual subjects from an independent ADNI1 cohort (n = 92). We ran a linear regression to determine the relationship between each subject’s spatial correlations and their two-year decline in visuospatial, memory, and functional (Functional Activities Questionnaire or FAQ) scores, while controlling for age, sex, education, and total atrophy burden.

Two-year decline was measured by regressing baseline scores from individual’s two-year scores.

•While subjects’ correlation to both the visuospatial (r = -0.51) and memory (r = -0.33) map showed significant relationships to visuospatial decline (p < 0.05), a Williams' test confirmed the ADNI-VS map is a significantly better predictor of visuospatial decline than the ADNI-MEM map (p = 0.04). Conversely, individuals’ decline in memory was correlated to both memory map correlation (r = -0.32) and visuospatial map (r = -0.29) correlation with no significant difference (p=0.96).

•Mixed effects model reveals the atrophy correlation is the only significant predictor for visuospatial decline while total atrophy burden is the only significant indicator for memory decline

•An individual’s correlation to the group visuospatial map is significantly correlated to their change in FAQ total score, while this relationship is not captured by their correlation to the group memory map.

•Mixed effects model reveals that visuospatial-related atrophy is the only significant indicator of FAQ (p<0.05).

•Visuospatial construction and FAQ scores serve as direct indicators of critical functional outcomes, including driving ability, independence, and safety.

Our results reveal real-world functional metrics are best explained by visuospatial-related atrophy patterns, rather than general amnestic markers.

•While memory decline tracks closely with overall global disease burden, visuospatial-specific atrophy acts as a much more precise, frequently overlooked predictor of practical behavioral change.

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