Risk of incident clinical diagnosis of Alzheimer's disease-type dementia attributable to pathology-confirmed vascular disease.
Risk of incident clinical diagnosis of Alzheimer's disease-type dementia attributable to pathology-confirmed vascular disease.
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DOI：
10.1016/j.jalz.2016.11.003
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发表时间：
2017-06
期刊：
影响因子：
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通讯作者：
SMART data consortium
中科院分区：
文献类型：
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作者：
Dodge HH;Zhu J;Woltjer R;Nelson PT;Bennett DA;Cairns NJ;Fardo DW;Kaye JA;Lyons DE;Mattek N;Schneider JA;Silbert LC;Xiong C;Yu L;Schmitt FA;Kryscio RJ;Abner EL;SMART data consortium
脑血管病变的存在可能增加AD临床诊断的风险。我们使用来自衰老和转变风险统计模型（SMART）研究的数据，研究了AD（可能和可能的AD）临床诊断的额外风险，这些数据来自于AD病理学以外的腔隙和大梗死的存在。SMART研究是一项纵向队列研究，有超过2000例尸检。我们创建了六种相互排斥的病理学模式，其结合了三个级别的AD病理学（低、中或高AD病理学）和两个级别的血管病理学（无腔隙和大梗死或有腔隙和/或大梗死）。腔隙和大面积梗死的共存导致只有当AD病理负荷低时，AD临床诊断的可能性才更高。我们的研究结果加强了AD病理学在临床AD诊断中的重要性。需要进一步协调血管病变的评估方法。
Presence of cerebrovascular pathology may increase the risk of clinical diagnosis of AD. We examined excess risk of incident clinical diagnosis of AD (probable and possible AD) posed by the presence of lacunes and large infarcts beyond AD pathology using data from the Statistical Modelling of Aging and Risk of Transition (SMART) study, a consortium of longitudinal cohort studies with over 2000 autopsies. We created six mutually exclusive pathology patterns combining three levels of AD pathology (low, moderate or high AD pathology) and two levels of vascular pathology (without lacunes and large infarcts or with lacunes and/or large infarcts). The coexistence of lacunes and large infarcts results in higher likelihood of clinical diagnosis of AD only when AD pathology burden is low. Our results reinforce the diagnostic importance of AD pathology in clinical AD. Further harmonization of assessment approaches for vascular pathologies is required.