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Mixed brain pathologies account for most dementia cases in community-dwelling older persons.
Neurology. 2007 Dec 11; 69(24):2197-204.Neur

Abstract

OBJECTIVE

To examine the spectrum of neuropathology in persons from the Rush Memory and Aging Project, a longitudinal community-based clinical-pathologic cohort study.

METHODS

The study includes older persons who agreed to annual clinical evaluation and brain donation. We examined the neuropathologic diagnoses, including Alzheimer disease (AD) (NIA-Reagan Criteria), cerebral infarctions, and Parkinson disease/Lewy body disease (PD/LBD), in the first 141 autopsies. We calculated the frequency of each diagnosis alone and mixed diagnoses. We used logistic regression to compare one to multiple diagnoses on the odds of dementia.

RESULTS

Twenty persons (14.2%) had no acute or chronic brain abnormalities. The most common chronic neuropathologic diagnoses were AD (n = 80), cerebral infarctions (n = 52), and PD/LBD (n = 24). In persons with dementia (n = 50), 38.0% (n = 19) had AD and infarcts, 30.0% (n = 15) had pure AD, and 12% each had vascular dementia (n = 6) and AD with PD/LBD (n = 6). In those without dementia (n = 91), 28.6% (n = 26) had no chronic diagnostic abnormalities, 24.2% (n = 22) had pure AD, and 17.6% (n = 16) had infarctions. In persons with dementia, over 50% had multiple diagnoses (AD, PD/LBD, or infarcts), whereas, in persons without dementia, over 80% had one or no diagnosis. After accounting for age, persons with multiple diagnoses were almost three times (OR = 2.8; 95% CI = 1.2, 6.7) more likely to exhibit dementia compared to those with one pathologic diagnosis.

CONCLUSION

The majority of community-dwelling older persons have brain pathology. Those with dementia most often have multiple brain pathologies, which greatly increases the odds of dementia.

Authors+Show Affiliations

Rush Alzheimer's Disease Center, Rush University Medical Center, Armour Academic Center, 600 S. Paulina Street, Suite 1022F, Chicago, IL 60612, USA. julie_a_schneider@rush.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

17568013

Citation

Schneider, Julie A., et al. "Mixed Brain Pathologies Account for Most Dementia Cases in Community-dwelling Older Persons." Neurology, vol. 69, no. 24, 2007, pp. 2197-204.
Schneider JA, Arvanitakis Z, Bang W, et al. Mixed brain pathologies account for most dementia cases in community-dwelling older persons. Neurology. 2007;69(24):2197-204.
Schneider, J. A., Arvanitakis, Z., Bang, W., & Bennett, D. A. (2007). Mixed brain pathologies account for most dementia cases in community-dwelling older persons. Neurology, 69(24), 2197-204.
Schneider JA, et al. Mixed Brain Pathologies Account for Most Dementia Cases in Community-dwelling Older Persons. Neurology. 2007 Dec 11;69(24):2197-204. PubMed PMID: 17568013.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mixed brain pathologies account for most dementia cases in community-dwelling older persons. AU - Schneider,Julie A, AU - Arvanitakis,Zoe, AU - Bang,Woojeong, AU - Bennett,David A, Y1 - 2007/06/13/ PY - 2007/6/15/pubmed PY - 2008/1/15/medline PY - 2007/6/15/entrez SP - 2197 EP - 204 JF - Neurology JO - Neurology VL - 69 IS - 24 N2 - OBJECTIVE: To examine the spectrum of neuropathology in persons from the Rush Memory and Aging Project, a longitudinal community-based clinical-pathologic cohort study. METHODS: The study includes older persons who agreed to annual clinical evaluation and brain donation. We examined the neuropathologic diagnoses, including Alzheimer disease (AD) (NIA-Reagan Criteria), cerebral infarctions, and Parkinson disease/Lewy body disease (PD/LBD), in the first 141 autopsies. We calculated the frequency of each diagnosis alone and mixed diagnoses. We used logistic regression to compare one to multiple diagnoses on the odds of dementia. RESULTS: Twenty persons (14.2%) had no acute or chronic brain abnormalities. The most common chronic neuropathologic diagnoses were AD (n = 80), cerebral infarctions (n = 52), and PD/LBD (n = 24). In persons with dementia (n = 50), 38.0% (n = 19) had AD and infarcts, 30.0% (n = 15) had pure AD, and 12% each had vascular dementia (n = 6) and AD with PD/LBD (n = 6). In those without dementia (n = 91), 28.6% (n = 26) had no chronic diagnostic abnormalities, 24.2% (n = 22) had pure AD, and 17.6% (n = 16) had infarctions. In persons with dementia, over 50% had multiple diagnoses (AD, PD/LBD, or infarcts), whereas, in persons without dementia, over 80% had one or no diagnosis. After accounting for age, persons with multiple diagnoses were almost three times (OR = 2.8; 95% CI = 1.2, 6.7) more likely to exhibit dementia compared to those with one pathologic diagnosis. CONCLUSION: The majority of community-dwelling older persons have brain pathology. Those with dementia most often have multiple brain pathologies, which greatly increases the odds of dementia. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/17568013/Mixed_brain_pathologies_account_for_most_dementia_cases_in_community_dwelling_older_persons_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=17568013 DB - PRIME DP - Unbound Medicine ER -