Visual system vulnerability in dementia: from detection to determinants

A fully funded PhD studentship at the EPSRC Centre for Doctoral Training in Digital Health Technologies

 Visual system vulnerability in dementia: from detection to determinants

Key information

Lead supervisors: Dr Keir Yong and Dr Andre Altmann
Application deadline: 30 May 2025
Interview dates: provisionally held in the first two weeks of June
Project start date: 01 October 2025
Project duration: 4 years
Location: UCL Bloomsbury Campus, London
Studentship funding: Home tuition fees (currently £6,035/year) and maintenance stipend (currently £22,780/year)

PhD project description

Cortical visual impairments (‘brainsight’, not eyesight loss) are disabling consequences of dementia associated with particular diagnostic and management needs. Such impairments have been reported in the majority of people with Alzheimer’s disease, particularly in posterior cortical atrophy (‘visual-led dementia’) where these symptoms precede loss of memory, language and insight.

People with dementia-related visual impairment are usually seen first by eye health professionals. They are frequently misdiagnosed with eye or psychological conditions, repeatedly change glasses or undergo surgery before determining their visual loss arises from cortical, rather than ocular deficits. Tests of cortical visual function are used rarely except by highly specialised neurology/neuro-ophthalmology diagnostic services. These diagnostic scenarios often delay diagnosis and treatment for years.

Key knowledge gaps and significance:

  • There is a lack of tests to detect brainsight loss and distinguish this from eyesight loss.

  • There is a gap in evidence-based tests to diagnose brainsight loss caused by dementia. There is a gap in tests suitable across eye and dementia clinic settings.

  • The reasons behind why some people with dementia are more susceptible to brainsight loss are largely unknown.

Determining the causes and consequences of visual system vulnerability in dementia has important fundamental and translational implications for understanding variable disease onset and progression.

Project outcomes include promoting equitable access to novel disease-modifying therapies targeting Alzheimer’s disease (one in ten people with Alzheimer’s disease have a visual, rather than memory-led form).

Project aims and objectives

Aim 1: Improve detection of visual-led dementia
Objective: Develop a test to detect dementia-related visual impairment in eye and dementia clinics

Aim 2: Evaluate factors associated with cortical visual function in UK Biobank
Objective: Derive a latent factor of cortical visual functioning in UK Biobank and evaluate candidate associated risk factors

Aim 3: Evaluate factors associated with visual system vulnerability in dementia
Objective: Compare genetic variants associated with cortical visual functioning and visual-led dementia

This studentship will incorporate neuropsychological, statistical and imaging genetics methodologies. Under the supervision of world-leading experts the candidate will address three related Projects:

Project 1: Developing and validating a cortical visual test
We have developed a digital test (Graded Incomplete Letter Test [GILT]) to rapidly detect and distinguish cortical visual from ocular losses. The GILT is adapted from standard tests to diagnose cortical visual impairment but is optimised for sensitivity and specificity. You will support validation of the GILT in the largest neuroimaging study worldwide (UK Biobank repeat imaging n=60,000) and dementia and eye clinic patients (National Hospital of Neurology and Neurosurgery, Moorfields Eye Hospital). You will relate GILT performance to clinical diagnoses and MRI and evaluate approaches to increase GILT sensitivity to damage to visual cortex.

Cortical visual test [GILT]

UK Biobank repeat imaging sub study

Project 2: Latent factor analysis of cortical visual functioning
You will derive a latent cortical visual factor in UK Biobank using computational and statistical techniques. This factor will index cortical visual integrity by incorporating visual tests (similar to a ‘language factor’ incorporating tests of vocabulary, comprehension and reading speed) and MRI measures. Analyses will be complemented by separate behavioural and MRI analyses of the largest study of visual-led dementia at UCL. You will evaluate relationships between this latent cortical visual factor, Alzheimer’s disease risk factors and UK Biobank measures of health and functional status.

Project 3: Discovery analysis
You will conduct a genetic analysis (known as genome wide association analysis or GWAS) to discover genetic markers (known as SNPs) associated with the Project 2 latent factor. You will compare SNP effects with genetic profiles of visual-led dementia using adjusted logistic and linkage disequilibrium score regression. Visual-led dementia groups will include the posterior cortical atrophy sample at UCL and Alzheimer’s disease patients with predominant visual loss participating in international data-sharing initiatives.

    This studentship will belong to Cohort 2 of the Centre for Doctoral Training in Digital Health Technologies and will benefit from:

    • CDT annual doctoral conference, bringing together current students and expert digital health scientists.
    • Partner ‘sandpits’, providing the opportunity to develop research ideas with real-world impact.
    • Equality, diversity and inclusion (EDI) training and wellbeing sessions
    • Patient, public involvement and engagement (PPIE) training.
    • A 3-month industry/clinical secondment (Year 1) including placements at international centres of excellence within the National Hospital for Neurology and Neurosurgery and Moorfields Eye Hospital and Industry secondments to develop digital visual assessment tools for national studies, diagnostic services and for clinical trials.
    •   Patient/public involvement activities supported by the UCL Dementia Research Centre and Rare Dementia Support service.

    Person specification

    • Applicants are preferred to have first-class undergraduate and/or master’s degrees (or equivalent) in a numerate discipline, preferably in mathematical, computational, biological, engineering or physical sciences subjects or a related discipline, with an interest in using technology to solve health problems.
    • Excellent organisational, interpersonal and communication skills, along with an interest in interdisciplinary research, are essential.
    • Experience in computer programming is essential.
    • Fluency and clarity in spoken English as well as good written English in accordance with UCL English requirements (TOEFL>92 or IELTS>6.5).

    Eligibility

    Open to UK, EU, and overseas students.

    Applications are particularly welcome from candidates from the UK or from the EU with settled or pre-settled status in the UK. Please refer to our website for further information about Home tuition fee eligibility.

    Please refer to this webpage for full eligibility criteria: Mechanical Engineering MPhil/PhD

    How to apply

    Eligible applicants should submit the following documents to j.kozak@ucl.ac.uk by 30 May 2025:

    1. CV
    2. Academic transcripts
    3. A personal statement giving your reasons for applying and an outline of your research interests.
    4. Contact details of at least two academic referees

    The supervisory team will arrange interviews for short-listed candidates asap after the deadline.

    Funding Provided

    This studentship will be part of the EPSRC Digital Health Technologies CDT, co-funded with The National Brain Appeal. The CDT provides opportunities for research and technical skills development along with industry and clinical secondments.

    Funding for: tuition fees at the home rate & an annual stipend (currently £22,780/year). Students will also have access to a research training support grant for consumables and conference costs. The annual stipend is set by UKRI and likely to increase per annum. 

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