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Distinguishing between neurodegenerative disease and disease-free aging: correlating neuropsychological evaluations and neuropathological studies in centenarians.
Psychosom Med 2002 May-Jun; 64(3):493-501PM

Abstract

OBJECTIVE

In an examination of disease-free aging and neurodegenerative disease in 100-year-olds, the New England Centenarian Study compared data from neuropsychological evaluations with postmortem brain studies of fourteen 100-year-olds to ascertain if the presence or absence of Alzheimer disease changes correlated with measured cognitive abilities.

METHODS

Fourteen of 74 centenarians who underwent annual extensive neuropsychological evaluation proceeded to postmortem neuropathological examination. CERAD criteria, emphasizing neuritic amyloid plaques and Braak and Braak staging of neurofibrillary tangles were used to assess the 14 brains.

RESULTS

Neuropsychological and neuropathological findings correlated well for four subjects with no dementia on testing (CDR = 0) and for six subjects with CDR scores in the dementia range (CDR = 1-5). In the latter group, Alzheimer's disease was diagnosed in four brains; Pick's disease was an etiological factor in the fifth and hippocampal sclerosis in the sixth. Correlation was low for four subjects: two subjects with no dementia on neuropsychological testing met CERAD neuropathological criteria for possible AD; two subjects with dementia on testing did not meet CERAD criteria for definite Alzheimer's disease and had otherwise minimal changes to correlate with the cognitive findings.

CONCLUSIONS

Lack of correlation between level of cognitive functioning and brain pathology in two subjects with no dementia raised the question of whether a functional reserve delayed the functional expression of pathological changes. For two subjects with dementia on testing, there appeared to be no sufficient pathological explanation for the extent of the cognitive changes; depression and such factors as environment, sensory impairment, and medical illness may all have played a role. There may also have been neuropathologic changes not detected by current methods.

Authors+Show Affiliations

Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. margery_silver@hms.harvard.eduNo 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

12021423

Citation

Silver, Margery H., et al. "Distinguishing Between Neurodegenerative Disease and Disease-free Aging: Correlating Neuropsychological Evaluations and Neuropathological Studies in Centenarians." Psychosomatic Medicine, vol. 64, no. 3, 2002, pp. 493-501.
Silver MH, Newell K, Brady C, et al. Distinguishing between neurodegenerative disease and disease-free aging: correlating neuropsychological evaluations and neuropathological studies in centenarians. Psychosom Med. 2002;64(3):493-501.
Silver, M. H., Newell, K., Brady, C., Hedley-White, E. T., & Perls, T. T. (2002). Distinguishing between neurodegenerative disease and disease-free aging: correlating neuropsychological evaluations and neuropathological studies in centenarians. Psychosomatic Medicine, 64(3), pp. 493-501.
Silver MH, et al. Distinguishing Between Neurodegenerative Disease and Disease-free Aging: Correlating Neuropsychological Evaluations and Neuropathological Studies in Centenarians. Psychosom Med. 2002;64(3):493-501. PubMed PMID: 12021423.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Distinguishing between neurodegenerative disease and disease-free aging: correlating neuropsychological evaluations and neuropathological studies in centenarians. AU - Silver,Margery H, AU - Newell,Kathy, AU - Brady,Christopher, AU - Hedley-White,E Tessa, AU - Perls,Thomas T, PY - 2002/5/22/pubmed PY - 2002/8/1/medline PY - 2002/5/22/entrez SP - 493 EP - 501 JF - Psychosomatic medicine JO - Psychosom Med VL - 64 IS - 3 N2 - OBJECTIVE: In an examination of disease-free aging and neurodegenerative disease in 100-year-olds, the New England Centenarian Study compared data from neuropsychological evaluations with postmortem brain studies of fourteen 100-year-olds to ascertain if the presence or absence of Alzheimer disease changes correlated with measured cognitive abilities. METHODS: Fourteen of 74 centenarians who underwent annual extensive neuropsychological evaluation proceeded to postmortem neuropathological examination. CERAD criteria, emphasizing neuritic amyloid plaques and Braak and Braak staging of neurofibrillary tangles were used to assess the 14 brains. RESULTS: Neuropsychological and neuropathological findings correlated well for four subjects with no dementia on testing (CDR = 0) and for six subjects with CDR scores in the dementia range (CDR = 1-5). In the latter group, Alzheimer's disease was diagnosed in four brains; Pick's disease was an etiological factor in the fifth and hippocampal sclerosis in the sixth. Correlation was low for four subjects: two subjects with no dementia on neuropsychological testing met CERAD neuropathological criteria for possible AD; two subjects with dementia on testing did not meet CERAD criteria for definite Alzheimer's disease and had otherwise minimal changes to correlate with the cognitive findings. CONCLUSIONS: Lack of correlation between level of cognitive functioning and brain pathology in two subjects with no dementia raised the question of whether a functional reserve delayed the functional expression of pathological changes. For two subjects with dementia on testing, there appeared to be no sufficient pathological explanation for the extent of the cognitive changes; depression and such factors as environment, sensory impairment, and medical illness may all have played a role. There may also have been neuropathologic changes not detected by current methods. SN - 0033-3174 UR - https://www.unboundmedicine.com/medline/citation/12021423/Distinguishing_between_neurodegenerative_disease_and_disease_free_aging:_correlating_neuropsychological_evaluations_and_neuropathological_studies_in_centenarians_ L2 - http://dx.doi.org/10.1097/00006842-200205000-00014 DB - PRIME DP - Unbound Medicine ER -