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Subcortical infarcts, Alzheimer's disease pathology, and memory function in older persons.

Abstract

OBJECTIVE

Examine the effects of subcortical infarcts with Alzheimer's disease (AD) pathology on dementia, episodic memory, and other cognitive abilities in older persons.

METHODS

Participants included 148 autopsied subjects of the Rush Memory and Aging Project (mean age, 88.0 years), a longitudinal clinicopathological study. Cognition was assessed yearly with 21 neuropsychological tests. Infarcts were visualized on coronal slabs, and plaques and neurofibrillary tangles were counted and standardized to form a composite measure of AD pathology. Multiple regression analyses were used controlling for age, sex, and education.

RESULTS

Fifty-three (35.8%) subjects had cerebral infarcts. After accounting for AD pathology, infarcts increased the odds of dementia by 5.1-fold (95% confidence interval, 1.98-12.92) and lowered cognitive function by 0.50 standard unit (p = 0.001). After controlling for cortical infarcts and AD pathology, subcortical infarcts, present in 39 of 53 (73.6%) subjects with infarcts, increased the odds of dementia by almost 4-fold and reduced cognitive function by more than a third of a unit (parameter estimate = -0.37; p = 0.03). In analyses with cognitive abilities, subcortical infarcts were associated with lower episodic, semantic, and working memory (p < or = 0.05), and had an interaction with AD pathology to further worsen working memory (p = 0.02).

INTERPRETATION

Subcortical infarcts add to deleterious effects of AD pathology by increasing the odds of dementia and lowering memory function.

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  • Authors+Show Affiliations

    ,

    Rush Alzheimer's Disease Center and Rush Institute for Healthy Aging, Department of Neurological Sciences, Rush University Medical Center, 600 South Paulina Street, Chicago, IL 60612, USA. julie_a_schneider@rush.edu

    , , ,

    Source

    Annals of neurology 62:1 2007 Jul pg 59-66

    MeSH

    Aged, 80 and over
    Alzheimer Disease
    Brain
    Cerebral Infarction
    Cohort Studies
    Female
    Geriatric Assessment
    Humans
    Male
    Memory
    Neuropsychological Tests
    Regression Analysis

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    17503514

    Citation

    Schneider, Julie A., et al. "Subcortical Infarcts, Alzheimer's Disease Pathology, and Memory Function in Older Persons." Annals of Neurology, vol. 62, no. 1, 2007, pp. 59-66.
    Schneider JA, Boyle PA, Arvanitakis Z, et al. Subcortical infarcts, Alzheimer's disease pathology, and memory function in older persons. Ann Neurol. 2007;62(1):59-66.
    Schneider, J. A., Boyle, P. A., Arvanitakis, Z., Bienias, J. L., & Bennett, D. A. (2007). Subcortical infarcts, Alzheimer's disease pathology, and memory function in older persons. Annals of Neurology, 62(1), pp. 59-66.
    Schneider JA, et al. Subcortical Infarcts, Alzheimer's Disease Pathology, and Memory Function in Older Persons. Ann Neurol. 2007;62(1):59-66. PubMed PMID: 17503514.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Subcortical infarcts, Alzheimer's disease pathology, and memory function in older persons. AU - Schneider,Julie A, AU - Boyle,Patricia A, AU - Arvanitakis,Zoe, AU - Bienias,Julia L, AU - Bennett,David A, PY - 2007/5/16/pubmed PY - 2007/10/13/medline PY - 2007/5/16/entrez SP - 59 EP - 66 JF - Annals of neurology JO - Ann. Neurol. VL - 62 IS - 1 N2 - OBJECTIVE: Examine the effects of subcortical infarcts with Alzheimer's disease (AD) pathology on dementia, episodic memory, and other cognitive abilities in older persons. METHODS: Participants included 148 autopsied subjects of the Rush Memory and Aging Project (mean age, 88.0 years), a longitudinal clinicopathological study. Cognition was assessed yearly with 21 neuropsychological tests. Infarcts were visualized on coronal slabs, and plaques and neurofibrillary tangles were counted and standardized to form a composite measure of AD pathology. Multiple regression analyses were used controlling for age, sex, and education. RESULTS: Fifty-three (35.8%) subjects had cerebral infarcts. After accounting for AD pathology, infarcts increased the odds of dementia by 5.1-fold (95% confidence interval, 1.98-12.92) and lowered cognitive function by 0.50 standard unit (p = 0.001). After controlling for cortical infarcts and AD pathology, subcortical infarcts, present in 39 of 53 (73.6%) subjects with infarcts, increased the odds of dementia by almost 4-fold and reduced cognitive function by more than a third of a unit (parameter estimate = -0.37; p = 0.03). In analyses with cognitive abilities, subcortical infarcts were associated with lower episodic, semantic, and working memory (p < or = 0.05), and had an interaction with AD pathology to further worsen working memory (p = 0.02). INTERPRETATION: Subcortical infarcts add to deleterious effects of AD pathology by increasing the odds of dementia and lowering memory function. SN - 0364-5134 UR - https://www.unboundmedicine.com/medline/citation/17503514/Subcortical_infarcts_Alzheimer's_disease_pathology_and_memory_function_in_older_persons_ L2 - https://doi.org/10.1002/ana.21142 DB - PRIME DP - Unbound Medicine ER -