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"Preclinical" AD revisited: neuropathology of cognitively normal older adults.
Neurology 2000; 55(3):370-6Neur

Abstract

OBJECTIVE

To classify neuropathologic alterations in the brains of nondemented older adults using current sets of criteria for AD.

BACKGROUND

AD neuropathologic alterations are found in the brains of some nondemented elderly subjects and suggest the possibility of presymptomatic AD. Three sets of guidelines have been developed to classify AD using senile plaques, neuritic plaques, and neurofibrillary tangles (NFT).

METHODS

Neuropathologic changes in 59 older adults followed longitudinally with a standard battery of mental status measures were investigated using Khachaturian, Consortium to Establish a Registry for Alzheimer's Disease (CERAD), and National Institute on Aging-Reagan Institute (NIA-RI) guidelines. AD neuropathologic markers were evaluated in neocortical and allocortical regions. Cases were categorized as neuropathologically "normal" or "AD-like" and compared for possible mental status differences.

RESULTS

Between 11 and 49% of cases met one or more of the three classifications of AD. With adjustments for multiple comparisons, only NFT in hippocampal CA1 region were associated with autopsy age, suggesting that this may represent a pathologic process associated with normal brain aging. Using the NIA-RI guidelines, subjects in the AD-like group performed less well on the immediate paragraph recall and word-list delayed recall than their counterparts who did not meet these guidelines.

CONCLUSIONS

These data indicate that the prevalence of "preclinical" AD in our population is relatively low based on the NIA-RI classification. Although many subjects had AD-like changes based on CERAD and Khachaturian guidelines, they exhibited no differences in mental performance, suggesting that the aging brain may be able to withstand such structural changes without meaningful impact on mental functioning.

Authors+Show Affiliations

Sanders-Brown Center on Aging and Alzheimer's Disease Research Center, Department of Neurology, University of Kentucky College of Medicine, Lexington 40536, USA. fas_com@coa.uky.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

10932270

Citation

Schmitt, F A., et al. ""Preclinical" AD Revisited: Neuropathology of Cognitively Normal Older Adults." Neurology, vol. 55, no. 3, 2000, pp. 370-6.
Schmitt FA, Davis DG, Wekstein DR, et al. "Preclinical" AD revisited: neuropathology of cognitively normal older adults. Neurology. 2000;55(3):370-6.
Schmitt, F. A., Davis, D. G., Wekstein, D. R., Smith, C. D., Ashford, J. W., & Markesbery, W. R. (2000). "Preclinical" AD revisited: neuropathology of cognitively normal older adults. Neurology, 55(3), pp. 370-6.
Schmitt FA, et al. "Preclinical" AD Revisited: Neuropathology of Cognitively Normal Older Adults. Neurology. 2000 Aug 8;55(3):370-6. PubMed PMID: 10932270.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - "Preclinical" AD revisited: neuropathology of cognitively normal older adults. AU - Schmitt,F A, AU - Davis,D G, AU - Wekstein,D R, AU - Smith,C D, AU - Ashford,J W, AU - Markesbery,W R, PY - 2000/8/10/pubmed PY - 2000/8/29/medline PY - 2000/8/10/entrez SP - 370 EP - 6 JF - Neurology JO - Neurology VL - 55 IS - 3 N2 - OBJECTIVE: To classify neuropathologic alterations in the brains of nondemented older adults using current sets of criteria for AD. BACKGROUND: AD neuropathologic alterations are found in the brains of some nondemented elderly subjects and suggest the possibility of presymptomatic AD. Three sets of guidelines have been developed to classify AD using senile plaques, neuritic plaques, and neurofibrillary tangles (NFT). METHODS: Neuropathologic changes in 59 older adults followed longitudinally with a standard battery of mental status measures were investigated using Khachaturian, Consortium to Establish a Registry for Alzheimer's Disease (CERAD), and National Institute on Aging-Reagan Institute (NIA-RI) guidelines. AD neuropathologic markers were evaluated in neocortical and allocortical regions. Cases were categorized as neuropathologically "normal" or "AD-like" and compared for possible mental status differences. RESULTS: Between 11 and 49% of cases met one or more of the three classifications of AD. With adjustments for multiple comparisons, only NFT in hippocampal CA1 region were associated with autopsy age, suggesting that this may represent a pathologic process associated with normal brain aging. Using the NIA-RI guidelines, subjects in the AD-like group performed less well on the immediate paragraph recall and word-list delayed recall than their counterparts who did not meet these guidelines. CONCLUSIONS: These data indicate that the prevalence of "preclinical" AD in our population is relatively low based on the NIA-RI classification. Although many subjects had AD-like changes based on CERAD and Khachaturian guidelines, they exhibited no differences in mental performance, suggesting that the aging brain may be able to withstand such structural changes without meaningful impact on mental functioning. SN - 0028-3878 UR - https://www.unboundmedicine.com/medline/citation/10932270/"Preclinical"_AD_revisited:_neuropathology_of_cognitively_normal_older_adults_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=10932270 DB - PRIME DP - Unbound Medicine ER -