Alzheimer disease pathology and longitudinal cognitive performance in the oldest-old with no dementia
Alzheimer disease pathology and longitudinal cognitive performance in the oldest-old with no dementia
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DOI：
10.1212/wnl.0b013e318266fc77
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发表时间：
2012-08-01
期刊：
影响因子：
9.9
通讯作者：
Corrada, Maria M.
中科院分区：
文献类型：
--
作者：
Balasubramanian, Archana B.;Kawas, Claudia H.;Corrada, Maria M.
目的：据推测，没有患有阿尔茨海默病（AD）神经病理学的痴呆症的个体可能处于痴呆症的临床前阶段，并且可能正在经历微妙的认知下降。本研究的目的是比较纵向的认知性能在最老的老年人没有痴呆症和AD neuropathics.Methods：本研究包括58个人没有痴呆症的90+尸检研究，人口为基础的研究，在90岁及以上的个人的老龄化和痴呆症。参与者每6个月进行一次神经和神经心理测试，平均随访3年。我们比较了AD神经病理学水平的改良简易精神状态检查（3 MS）和加州言语学习测试II（CVLT）的认知表现轨迹。基于建立阿尔茨海默病斑块分期登记的联盟，个体被分类为具有低（无或稀疏）或高（中度或频繁）斑块。根据Braak和Braak分期，参与者被归类为具有低（阶段I-III）或高（IV-VI）tangle.Results：没有显着差异，发现在3 MS或CVLT认知性能随着时间的推移，斑块或缠结分期的基础上。高和低病理组表现出适度的改善3 MS和CVLT与learning effects.Conclusions一致：AD神经病理学在尸检是不相关的轨迹的认知性能在3年前死亡的最老的老年痴呆症。尽管死亡时存在AD神经病理学，但没有痴呆的高龄老人在认知测试中显示出学习效果。进一步的研究是必要的，以了解AD神经病理学以外的因素，可能会影响认知在最年长的老人。神经病学（R）2012;79：915-921
Objective: It has been hypothesized that individuals without dementia with Alzheimer disease (AD) neuropathology may be in the preclinical stages of dementia and could be experiencing subtle cognitive decline. The purpose of this study was to compare longitudinal cognitive performance in oldest-old individuals without dementia with and without AD neuropathology.Methods: The study included 58 individuals without dementia from The 90+ Autopsy Study, a population-based study of aging and dementia in individuals aged 90 and older. Participants had neurologic and neuropsychological testing every 6 months with an average of 3 years of follow-up. We compared the trajectory of cognitive performance on the Modified Mini-Mental State Examination (3MS) and the California Verbal Learning Test II (CVLT) by level of AD neuropathology. Based on Consortium to Establish a Registry for Alzheimer's Disease plaque staging, individuals were categorized as having low (none or sparse) or high (moderate or frequent) plaques. Based on Braak and Braak staging, participants were classified as having low (stages I-III) or high (IV-VI) tangles.Results: No significant differences were found in 3MS or CVLT cognitive performance over time based on plaque or tangle staging. Both high and low pathology groups showed modest improvements on the 3MS and CVLT consistent with learning effects.Conclusions: AD neuropathology at autopsy is not associated with the trajectory of cognitive performance in the 3 years before death in oldest-old without dementia. Despite the presence of AD neuropathology at death, oldest-old without dementia display learning effects on cognitive tests. Further research is necessary to understand factors other than AD neuropathology that may affect cognition in the oldest-old. Neurology (R) 2012;79:915-921