B - 147 Neuropsychological Evaluation of a Blind Patient with Suspected Lewy Body Dementia

Abstract Objective Assessment of patients who are blind can be complicated. In patients with Lewy body dementia (LBD), visuospatial abilities are often impaired early but assessment of these abilities is limited in patients who are blind. This case involved neuropsychological evaluation of a patient who is blind with suspected LBD and aims to expand existing literature. Method 75-year-old, blind (since early 20s) Caucasian female with onset of progressive cognitive decline 18 months prior and motor symptoms 12 months prior. Functional decline, cognitive fluctuations, hallucinations, and possible Rapid Eye Movement behavioral disorder were endorsed. MRI of the brain revealed “diffusely prominent perivascular spaces” and “chronic white matter ischemia”. Results Testing found deficits for verbal fluency, processing speed, working memory, and cognitive flexibility. This fronto-subcortical pattern of cognitive dysfunction and functional decline met criteria for mild dementia. Memory performance was variable but not indicative of Alzheimer’s dementia. History and symptoms raise concern for an underlying LBD. With vision loss, Charles Bonnet syndrome (CBS) is a potential cause of some of the hallucinations but does not account for the other symptoms reported, which better support an LBD etiology. Conclusions This presentation aims to contribute to the limited literature surrounding assessment of LBD in patients who are blind. Aside from the obvious test selection restrictions, finding relevant research and available normative data surrounding neuropsychological assessment in this population is difficult due to the different causes and levels of vision impairment. Limited research surrounding the evaluation and diagnosis of LBD in patients who are blind further complicate this case.