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Neuropathology of older persons without cognitive impairment from two community-based studies.

Abstract

OBJECTIVE

To examine the relation of National Institute on Aging-Reagan (NIA-Reagan) neuropathologic criteria of Alzheimer disease (AD) to level of cognitive function in persons without dementia or mild cognitive impairment (MCI).

METHODS

More than 2,000 persons without dementia participating in the Religious Orders Study or the Memory and Aging Project agreed to annual detailed clinical evaluation and brain donation. The studies had 19 neuropsychological performance tests in common that assessed five cognitive domains, including episodic memory, semantic memory, working memory, perceptual speed, and visuospatial ability. A total of 134 persons without cognitive impairment died and underwent brain autopsy and postmortem assessment for AD pathology using NIA-Reagan neuropathologic criteria for AD, cerebral infarctions, and Lewy bodies. Linear regression was used to examine the relation of AD pathology to level of cognitive function proximate to death.

RESULTS

Two (1.5%) persons met NIA-Reagan criteria for high likelihood AD, and 48 (35.8%) met criteria for intermediate likelihood; 29 (21.6%) had cerebral infarctions, and 18 (13.4%) had Lewy bodies. The mean Mini-Mental State Examination score proximate to death was 28.2 for those meeting high or intermediate likelihood AD by NIA-Reagan criteria and 28.4 for those not meeting criteria. In linear regression models adjusted for age, sex, and education, persons meeting criteria for intermediate or high likelihood AD scored about a quarter standard unit lower on tests of episodic memory (p = 0.01). There were no significant differences in any other cognitive domain.

CONCLUSIONS

Alzheimer disease pathology can be found in the brains of older persons without dementia or mild cognitive impairment and is related to subtle changes in episodic memory.

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  • Authors+Show Affiliations

    ,

    Rush Alzheimer's Disease Center, Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA. dbennett@rush.edu

    , , , , ,

    Source

    Neurology 66:12 2006 Jun 27 pg 1837-44

    MeSH

    Age Factors
    Aged, 80 and over
    Aging
    Alzheimer Disease
    Bias
    Cognition Disorders
    Community Health Services
    Comorbidity
    Dementia
    Female
    Humans
    Incidence
    Male
    Neuropsychological Tests
    Reproducibility of Results
    Risk Assessment
    Risk Factors
    Sensitivity and Specificity
    Statistics as Topic
    United States

    Pub Type(s)

    Clinical Trial
    Journal Article
    Multicenter Study
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    16801647

    Citation

    Bennett, D A., et al. "Neuropathology of Older Persons Without Cognitive Impairment From Two Community-based Studies." Neurology, vol. 66, no. 12, 2006, pp. 1837-44.
    Bennett DA, Schneider JA, Arvanitakis Z, et al. Neuropathology of older persons without cognitive impairment from two community-based studies. Neurology. 2006;66(12):1837-44.
    Bennett, D. A., Schneider, J. A., Arvanitakis, Z., Kelly, J. F., Aggarwal, N. T., Shah, R. C., & Wilson, R. S. (2006). Neuropathology of older persons without cognitive impairment from two community-based studies. Neurology, 66(12), pp. 1837-44.
    Bennett DA, et al. Neuropathology of Older Persons Without Cognitive Impairment From Two Community-based Studies. Neurology. 2006 Jun 27;66(12):1837-44. PubMed PMID: 16801647.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Neuropathology of older persons without cognitive impairment from two community-based studies. AU - Bennett,D A, AU - Schneider,J A, AU - Arvanitakis,Z, AU - Kelly,J F, AU - Aggarwal,N T, AU - Shah,R C, AU - Wilson,R S, PY - 2006/6/28/pubmed PY - 2006/7/20/medline PY - 2006/6/28/entrez SP - 1837 EP - 44 JF - Neurology JO - Neurology VL - 66 IS - 12 N2 - OBJECTIVE: To examine the relation of National Institute on Aging-Reagan (NIA-Reagan) neuropathologic criteria of Alzheimer disease (AD) to level of cognitive function in persons without dementia or mild cognitive impairment (MCI). METHODS: More than 2,000 persons without dementia participating in the Religious Orders Study or the Memory and Aging Project agreed to annual detailed clinical evaluation and brain donation. The studies had 19 neuropsychological performance tests in common that assessed five cognitive domains, including episodic memory, semantic memory, working memory, perceptual speed, and visuospatial ability. A total of 134 persons without cognitive impairment died and underwent brain autopsy and postmortem assessment for AD pathology using NIA-Reagan neuropathologic criteria for AD, cerebral infarctions, and Lewy bodies. Linear regression was used to examine the relation of AD pathology to level of cognitive function proximate to death. RESULTS: Two (1.5%) persons met NIA-Reagan criteria for high likelihood AD, and 48 (35.8%) met criteria for intermediate likelihood; 29 (21.6%) had cerebral infarctions, and 18 (13.4%) had Lewy bodies. The mean Mini-Mental State Examination score proximate to death was 28.2 for those meeting high or intermediate likelihood AD by NIA-Reagan criteria and 28.4 for those not meeting criteria. In linear regression models adjusted for age, sex, and education, persons meeting criteria for intermediate or high likelihood AD scored about a quarter standard unit lower on tests of episodic memory (p = 0.01). There were no significant differences in any other cognitive domain. CONCLUSIONS: Alzheimer disease pathology can be found in the brains of older persons without dementia or mild cognitive impairment and is related to subtle changes in episodic memory. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/16801647/Neuropathology_of_older_persons_without_cognitive_impairment_from_two_community_based_studies_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=16801647 DB - PRIME DP - Unbound Medicine ER -