Alzheimer neuropathologic alterations in aged cognitively normal subjects
Alzheimer neuropathologic alterations in aged cognitively normal subjects
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DOI：
10.1097/00005072-199904000-00008
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发表时间：
1999-04-01
影响因子：
3.2
通讯作者：
Markesbery, WR
中科院分区：
文献类型：
--
作者：
Davis, DG;Schmitt, FA;Markesbery, WR
早期阿尔茨海默病（AD）与正常或病理性衰老的组织病理学变化尚未明确定义。本报告描述了59名受过良好教育的老年志愿者的尸检结果。作为我们正常老化研究的一部分，他们接受了纵向精神状态测试，有些长达8年。本研究发现：（1）许多在神经心理学测试中未表现出认知功能损害的受试者的大脑中含有丰富的老年斑（SP）和/或神经纤维缠结（NFT），（2）29名受试者符合Khachaturian的AD诊断标准，15名符合CERAD，7名符合美国国家老龄研究所-里根研究所的指南;（3）Braak和Braak分期法：IV期9例，V期4例，VI期1例，（4）NFT从内嗅皮层向海马和杏仁核的发展与年龄有关;（5）3名受试者符合路易体痴呆的诊断标准，但未痴呆;（6）75%的受试者的软脑膜血管和62%的受试者的实质血管中存在脑淀粉样血管病;（7）59例受试者中仅有10例（17%）无或仅有少量退行性脑改变。我们的研究表明，在认知正常、受教育程度相对较高的人群中，大部分人的大脑都存在许多退行性变化，只有一小部分人的大脑相对没有这些变化。
The histopathologic changes distinguishing early Alzheimer disease (AD) from normal or pathologic aging are not clearly defined. This report describes the autopsy findings of 59 elderly, well-educated, volunteers. They were examined longitudinally with mental status testing, some for up to 8 years, as part of our normal aging study. This study reveals that (1) the brains of many subjects who did not show cognitive impairment on neuropsychologic testing contain abundant senile plaques (SP) and/or neurofibrillary tangles (NFT); (2) 29 subjects met Khachaturian criteria for AD, 15 met CERAD and 7 met National Institute on Aging-Reagan Institute guidelines; (3) Braak and Braak staging method included 9 in stage IV subjects, 4 in stage V, and 1 in stage VI; (4) there was a progression of NFT from entorhinal cortex to hippocampus and amygdala as a function of age; (5) 3 subjects met criteria for a diagnosis of dementia with Lewy bodies but were not demented; (6) cerebral amyloid angiopathy was present in leptomeningeal vessels in 75% of subjects and in parenchymal vessels in 62% of subjects; (7) only 10 of 59 subjects (17%) had no or few degenerative brain changes. Our study demonstrates that the brains of a large percentage of cognitively normal, relatively well-educated individuals contain numerous degenerative changes and only a small percentage are relatively free of these changes.