Functional and motor assessment in Patients affected by cognitive decline

Purpose: Cognitive decline is the progressive loss and deterioration of the intellectual functioning triggered by chronic degenerative processes. It is caused by Alzheimer and other degenerative diseases that affect the frontal and temporal lobes of the brain. Furthermore, alterations in cerebral blood vessels could contribute to the cerebrovascular diseases. In this study we evaluated the correlations between patients with visual and cognitive impairment. Methods: Patients received a comprehensive ophthalmic and orthoptic examination, in particular a reading speed test in words per minute. Our sample included 108 subjects, 50 males and 58 females, age range 65-103 years. 40 patients with mild to moderate cognitive impairment, 28 with vascular dementia, 24 with Alzheimer's disease and 16 with Parkinson's disease. Results: The reading speed test showed data considerably below the average in 64% of the patients. The Titmus stereo-test revealed absent or little stereopsis in 68% of the subjects. We detected frequent elevation deficiencies, deficits in the medial rectus muscles (43%) and in the inferior oblique muscles (23%). We found a majority of exodeviations and convergence insufficiency, particularly in subjects with Parkinson's disease. In the red filter test, the majority of subjects gave a fusion response at near rather than at distance. Conclusions: alterations in reading, reduction in visual acuity, deficient stereopsis were observed in those subjects with cognitive impairment. However, visual impairment frequently results from vision problems not adequately treated. This, we highlight the need to define adequate treatment and prevention programmes.