Visual and Spatial Problems

Having problems navigating your space is one of the earliest signs of Alzheimer’s disease. Spatial and vision issues as well as memory impairment are common. These problems can affect a person’s confidence and willingness to leave their home.¹

Spatial and visual problems that people with Alzheimer’s have can include:¹

• Getting lost
• Becoming confused in new places
• Trouble identifying objects and people

But there are ways to minimize the confusion of the person with Alzheimer's. You can make them more comfortable. Creating systems that can help is key to improving quality of life.

Types and causes of visual and spatial problems

There are 2 main categories of visual/spatial issues:²

• Misperceptions or misidentifications
• Difficulty with spatial reasoning and navigation

These 2 categories both come from damage to neurons. Neurons are the cells in your brain that communicate with each other and with the rest of your body. Alzheimer’s causes damage to neurons.²

Misperceptions and misidentifications

Misperceptions occur when a person sees one object as something different. For example, they might see a black rug as a hole in the ground, or blue flooring as water. Misidentifications are similar. But they happen when someone has difficulty identifying a person or thing. For example, the person may misidentify their child as their spouse.²

Misperceptions happen when someone has damage to their occipital lobe. This lobe is in the back of the brain. It processes visual information. So damage may cause someone not to be able to interpret what they see in front of them accurately.²

In contrast, misidentifications happen when someone has damage to their temporal and parietal lobes. These are the parts of the brain responsible for identifying faces and objects.²

Spatial reasoning and navigation

Problems with spatial reasoning and navigation are another common obstacle for people with Alzheimer’s. For example, the person may not be able to:^1-3

• Relate where they are to an object (for example, “the door is to the right of me”)
• Think objectively about where things are (for example, “the house is south of the school”)
• Judge distances accurately

The person with Alzheimer's could also have problems with remembering spaces, recognizing objects, navigating, and relating objects to each other in space. It is not clear whether this is caused by damage to the part of the brain that takes care of spatial reasoning. It is possible that these difficulties are caused by more general cognitive (thinking) problems from Alzheimer’s.^1-3

What to do about visual and spatial problems

There is no specific treatment for visual and spatial issues. But there are several things caregivers can do to make it easier for a person with Alzheimer’s to navigate without getting confused.

In their home, a few things can be helpful. Removing clutter and labeling can create familiarity. People who experience visual or spatial problems might rely more on habit than their own senses. So keeping things consistent can be helpful. For example, do not move furniture around or change where things are kept.^2,4

Someone with Alzheimer’s who is struggling with spatial issues may feel unsure about their surroundings. When they make mistakes, correct them gently while reassuring them and listening to their perspective on things. This approach can help to build their confidence and willingness to go places.²