Vascular pathologies and cognition in a population-based cohort of elderly people
Vascular pathologies and cognition in a population-based cohort of elderly people
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DOI：
10.1016/j.jns.2004.09.004
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发表时间：
2004-11-15
影响因子：
4.4
通讯作者：
Ince, PG
中科院分区：
文献类型：
--
作者：
Fernando, MS;Ince, PG
MRC认知功能和老龄化研究（CFAS）是一项前瞻性纵向研究，在英国六个地点进行了基于人群的老年人队列研究，使用心理测量仪器和问卷进行评估，以阐明身心健康状况。核心研究的数据包括痴呆症的患病率和发病率，认知能力下降的纵向测量以及痴呆症遗传风险因素的数据。一项神经病理学研究与核心研究合作进行，该研究基于个体受访者或护理者的死前咨询。对前209例累积脑捐赠的病理数据进行分析表明，阿尔茨海默型病理（ATP）和血管病理（包括嗜酸性淀粉样血管病（CAA））在痴呆和非痴呆受访者中均很常见。虽然许多病例符合阿尔茨海默病病理诊断的常规诊断标准，但这些数据与医院或记忆诊所队列的常规研究结果不同。特别是，有些人的病理总负担与他们的临床痴呆状态相比不适当地高或低，即使在痴呆风险因素的多变量模型中考虑所有病理（25%的受访者被误诊为病理结果）。血管病变是如此常见，以至于很少有痴呆病例缺乏ATP和血管病变的混合成分（纯AD病例，21%）。最近，该研究检查了该队列中的白色病理学，作为衰老大脑中小血管疾病（SVD）的潜在表现。使用MRI策略对福尔马林固定的脑切片进行成像，该研究表明白色病变（WML）很常见（总频率为94%），并且使用多变量分析是痴呆症的独立风险因素。(C)2004 Elsevier B.V.保留所有权利。
The MRC Cognitive Function and Ageing Study (CFAS) is a prospective longitudinal study of a population-based cohort of elderly people in six UK sites, evaluated using psychometric instruments and questionnaires to elucidate physical and mental health. Data from the core study includes prevalence and incidence rates for dementia and longitudinal measures of cognitive decline together with data on genetic risk factors for dementia. A neuropathology study runs in collaboration with the core study based on premortem counselling of individual respondents or carers. Analysis of pathological data from the first 209 accumulated brain donations showed that both Alzheimer-type pathologies (ATP) and vascular pathologies (including congophilic amyloid angiopathy (CAA)) were common in both demented and non-demented respondents. Although many cases fulfil conventional diagnostic criteria for the pathological diagnosis of Alzheimer disease, the data differ from those published from conventional studies of hospital or memory clinic cohorts. In particular, there are individuals whose total burden of pathology is inappropriately high or low compared with their clinical dementia status, even when all pathologies are considered in a multivariable model of dementia risk factors (25% of respondents misdiagnosed from pathology findings). Vascular pathology is so common that few dementia cases lack a mixed component of both ATP and vascular lesions (pure AD cases, 21%). More recently, the study has examined white matter pathology in this cohort as a potential manifestation of small-vessel disease (SVD) in the ageing brain. Using an MRI strategy to image formalin-fixed brain slices, the study shows that white matter lesions (WMLs) are common (94% overall frequency) and are an independent risk factor for dementia using multivariable analysis. (C) 2004 Elsevier B.V. All rights reserved.