A Population-Based Clinicopathological Study in the Oldest-Old: The 90+Study
A Population-Based Clinicopathological Study in the Oldest-Old: The 90+Study
复制标题
DOI：
10.2174/156720512801322537
复制
发表时间：
2012-07-01
影响因子：
2.1
通讯作者：
Kawas, Claudia H.
中科院分区：
文献类型：
--
作者：
Corrada, Maria M.;Berlau, Daniel J.;Kawas, Claudia H.
以人群为基础的纵向临床病理研究提供了一个理想的机会来研究代表一般人群的个体中与痴呆相关的各种风险和保护因素。这项90+研究是一项基于人群的研究，专门设计用于研究90岁及以上参与者的衰老和痴呆症及其神经病理相关性。我们提供了这项研究的大脑捐赠部分--90+尸检研究--的第一批104名参与者的人口统计和病理数据。认知诊断根据诊断和统计手册第四版痴呆症标准进行分配，神经病理诊断根据建立阿尔茨海默病登记方案的联合会进行。61%的尸检参与者患有痴呆症，其中大多数人被诊断为阿尔茨海默病(85%)。许多典型的与痴呆症相关的不同类型的病理在最年长的老年人中很常见，包括神经原纤维缠结、神经炎斑块、弥漫性斑块、路易小体、海马硬化症和脑梗塞。大多数类型的病理在患有痴呆症的参与者中更常见，但在患有痴呆症和不患有痴呆症的参与者中，病理学上存在广泛的重叠。此外，22%的痴呆症参与者没有足够的病理来解释他们的认知损失。我们的结果突出了这些常见的病理损害与老年期痴呆症之间的不良相关性，以及考虑许多不同类型的病理的重要性，可能包括一些尚未确定的病理类型，以解释老年期的所有痴呆。
Population-based longitudinal clinicopathological studies provide an ideal opportunity to study a variety of risk and protective factors in relation to pathology associated with dementia in individuals who are representative of the general population. The 90+ Study is a population-based study designed specifically to study aging and dementia as well as its neuropathological correlates in participants 90 years of age and older. We present demographic and pathological data on the first 104 participants to come to autopsy from the brain donation component of the study, The 90+ Autopsy Study. Cognitive diagnosis was assigned according to Diagnostic and Statistical Manual 4th edition criteria for dementia and neuropathological diagnoses were made according to the Consortium to Establish a Registry for Alzheimer's Disease protocol. Dementia was present in 61% of autopsied participants, the majority of whom were diagnosed with Alzheimer's disease (85%). Many different types of pathology typically associated with dementia were common in the oldest-old, and included neurofibrillary tangles, neuritic plaques, diffuse plaques, Lewy bodies, hippocampal sclerosis, and cerebral infarctions. Most types of pathology were more frequently found in participants suffering from dementia but there was extensive overlap in pathology among those with and without dementia. In addition, 22% of demented participants did not have sufficient pathology to account for their cognitive loss. Our results highlight the poor associations between these common pathological lesions and dementia in the oldest-old and the importance of considering many different types of pathology, possibly including some yet to be identified, in order to account for all dementias in the oldest-old.