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Cerebral infarctions and the likelihood of dementia from Alzheimer disease pathology.
Neurology. 2004 Apr 13; 62(7):1148-55.Neur

Abstract

BACKGROUND

Alzheimer disease (AD) is the most common cause of dementia. The effect of cerebral infarctions on the likelihood of dementia from AD pathology is not well understood.

METHODS

The study included 153 deceased Catholic clergy who participated in the Religious Orders Study. Annual evaluations, including 19 tests of cognitive function, were performed to determine a diagnosis of dementia and level of cognitive abilities proximate to death. At autopsy, neuritic and diffuse plaques and neurofibrillary tangles were counted and combined into a standardized summary measure of AD pathology. Number, volume, side, and distribution of old macroscopic infarctions were recorded. Analyses included logistic and linear regression, adjusting for age, sex, and education.

RESULTS

The AD pathology score ranged from 0 to 2.93 units, and 54 persons had infarctions. There was no relationship between AD pathology and infarctions (r = 0.04, p = 0.56). Each unit of AD pathology increased the odds of dementia by 4.40-fold (95% CI = 2.33 to 8.32), and this was essentially unchanged after accounting for infarctions. The presence of one or more infarctions independently increased the odds of dementia by 2.80-fold (95% CI = 1.26 to 6.21). There was no interaction between AD pathology and infarctions to further increase the likelihood of dementia (p = 0.39). The number, size, and distribution of infarctions added to the odds of dementia but also did not show an interaction with AD pathology. Similar results were found in analyses with global cognitive function and five different cognitive systems.

CONCLUSION

Cerebral infarctions independently contribute to the likelihood of dementia but do not interact with AD pathology to increase the likelihood of dementia beyond their additive effect.

Authors+Show Affiliations

Rush Alzheimer's Disease Center and Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612, USA. julie_a_schneider@rush.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

15079015

Citation

Schneider, J A., et al. "Cerebral Infarctions and the Likelihood of Dementia From Alzheimer Disease Pathology." Neurology, vol. 62, no. 7, 2004, pp. 1148-55.
Schneider JA, Wilson RS, Bienias JL, et al. Cerebral infarctions and the likelihood of dementia from Alzheimer disease pathology. Neurology. 2004;62(7):1148-55.
Schneider, J. A., Wilson, R. S., Bienias, J. L., Evans, D. A., & Bennett, D. A. (2004). Cerebral infarctions and the likelihood of dementia from Alzheimer disease pathology. Neurology, 62(7), 1148-55.
Schneider JA, et al. Cerebral Infarctions and the Likelihood of Dementia From Alzheimer Disease Pathology. Neurology. 2004 Apr 13;62(7):1148-55. PubMed PMID: 15079015.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cerebral infarctions and the likelihood of dementia from Alzheimer disease pathology. AU - Schneider,J A, AU - Wilson,R S, AU - Bienias,J L, AU - Evans,D A, AU - Bennett,D A, PY - 2004/4/14/pubmed PY - 2004/8/3/medline PY - 2004/4/14/entrez SP - 1148 EP - 55 JF - Neurology JO - Neurology VL - 62 IS - 7 N2 - BACKGROUND: Alzheimer disease (AD) is the most common cause of dementia. The effect of cerebral infarctions on the likelihood of dementia from AD pathology is not well understood. METHODS: The study included 153 deceased Catholic clergy who participated in the Religious Orders Study. Annual evaluations, including 19 tests of cognitive function, were performed to determine a diagnosis of dementia and level of cognitive abilities proximate to death. At autopsy, neuritic and diffuse plaques and neurofibrillary tangles were counted and combined into a standardized summary measure of AD pathology. Number, volume, side, and distribution of old macroscopic infarctions were recorded. Analyses included logistic and linear regression, adjusting for age, sex, and education. RESULTS: The AD pathology score ranged from 0 to 2.93 units, and 54 persons had infarctions. There was no relationship between AD pathology and infarctions (r = 0.04, p = 0.56). Each unit of AD pathology increased the odds of dementia by 4.40-fold (95% CI = 2.33 to 8.32), and this was essentially unchanged after accounting for infarctions. The presence of one or more infarctions independently increased the odds of dementia by 2.80-fold (95% CI = 1.26 to 6.21). There was no interaction between AD pathology and infarctions to further increase the likelihood of dementia (p = 0.39). The number, size, and distribution of infarctions added to the odds of dementia but also did not show an interaction with AD pathology. Similar results were found in analyses with global cognitive function and five different cognitive systems. CONCLUSION: Cerebral infarctions independently contribute to the likelihood of dementia but do not interact with AD pathology to increase the likelihood of dementia beyond their additive effect. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/15079015/Cerebral_infarctions_and_the_likelihood_of_dementia_from_Alzheimer_disease_pathology_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=15079015 DB - PRIME DP - Unbound Medicine ER -