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Alzheimer's Association International Conference 2026

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

9703

Posterior Cortical Atrophy: Clinical, Cognitive, And Neuroimaging Features From An Indian Cohort

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Poster Presenter

Sahil Mathur

Authors

Sahil Mathur, Prathima Alevoor Raghavendra, Rutul Shah, Faheem Arshad, Advoida Sabu, Sarath Govindaraj, Tejendra Singh, Jeevendra Kumar Darshini, Subasree Ramakrishnan, Vandana V P, Suvarna Alladi

Affiliations

Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Department of Speech Pathology and Audiology, National Institute of Mental Health and Neurosciences, Bengaluru

Part of Topic

Introduction:

Background

•Posterior cortical atrophy (PCA) is a progressive neurodegenerative disorder characterized by visuospatial, visuoperceptual, and symbolic deficits.1,2

•Despite well-defined diagnostic criteria, it remains understudied, particularly in South Asian diverse populations.4

•

Aims:

1.To characterize the clinical and cognitive features of PCA in a culturally and linguistically diverse Indian cohort—diagnosed using validated tools and the current consensus classification.

2.To examine the factors associated with cognitive performance, characterize the hemispheric differences in clinical manifestations, and study the survival outcomes in PCA.

Materials and Methods:

Design & Participants

•Retrospective study at a Cognitive Disorders Clinic, tertiary-care institute in South India

•From CDC registry: 943 AD patients (2016–2025) screened; two reviewers independently identified cases meeting 2017 consensus PCA criteria2

Clinical & Cognitive Assessment

•Demographics/clinical features from first consultation; severity staged by CDR

•Cognition: ACE-III (attention, memory, language, fluency, visuospatial + global), validated across Indian languages

•Parieto-occipital features (simultagnosia, object/space perception, visuospatial/symbolic deficits) via 2-D/3-D construction, dot counting, fragmented letters, reading/writing/calculation.4

•Longitudinal outcomes via telephonic follow-up (current CDR/cause of death).

Neuroimaging

•3T MRI in 46/50 patients; FDG-PET in 18 additional patients

•Interrater reliability- 0.86 (95% CI: 0.81–0.91)

Variable	Mean (SD)/ N(%)
Mean age of patients	57.9 (8.58) [42-80]
Age at onset	54.8 (8.38) [40-78]
Males	25 (50%)
Bilinguals	23 (46%)
Duration of illness (months)	35.2 (14.9)

ACE Outcome	R2	B (SE)
Visuospatial	0.21	0.82 (0.38)**
Attention	0.15	0.14 (0.06)**
Memory	0.08	0.15 (0.10)
Language	0.05	0.07 (0.10)
Fluency	0.05	0.05 (0.07)
ACE Total	0.12	0.58 (0.29)

Clinical features	Left (n-17)	Right (n-8)	Symmetric (n=17)
Acalculia	12	5	12
Agraphia	12	3	11
Finger Agnosia	5	2	4
Right-Left Confusion	10	3	9
Language deficits	6	0	5

Clinical outcome variable	Value
Mean duration of follow-up in years	3.2
Status at last follow-up (n=30) Alive, n (%) Deceased, n (%) [M: F]	16 (53.3) 14 (46.7) [10:4]
CDR at last follow-up (n-16) CDR=2 CDR=3	5 (31.25) 11(68.75)
Median survival from symptom onset	8

Conclusion:

•Largest PCA cohort from a diverse South Asian population assessed with cognitive tools validated across multiple languages.

•A notably higher rate of dressing apraxia reflecting the demands of culturally specific garments.

•Advanced disease severity at presentation underscores late PCA diagnosis and a critical barrier to early identification and intervention—especially important in the era of disease-modifying therapies.

•Way forward:These findings make a strong case for culturally appropriate deep cognitive phenotyping and greater representation of diverse global populations; larger cohorts with systematic evaluation frameworks warranted.

References:

1.S.J. Crutch et al. Posterior cortical atrophy, Lancet Neurol. 2012

2.JM Schott et al. Consensus classification of posterior cortical atrophy, Alz & Dem. 2017

3.M Chapleau et al. Demographic, clinical, biomarker, and neuropathological correlates of PCA. 2024

4.V.SPelaket al. Consensus recommendations for clinical assessment tools for the diagnosis of PCA. Alz & Dem. 2023

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