AD lesions and infarcts in demented and non-demented Japanese-American men
AD lesions and infarcts in demented and non-demented Japanese-American men
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DOI：
10.1002/ana.20318
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发表时间：
2005-01-01
影响因子：
11.2
通讯作者：
White, LR
中科院分区：
文献类型：
--
作者：
Petrovitch, H;Ross, GW;White, LR
新皮质神经炎斑块和神经原纤维缠结是痴呆的标志性神经病理损害。伴随的脑血管病变会增加符合阿尔茨海默病神经病理学标准的患者的痴呆严重程度，并导致轻度内源性阿尔茨海默病患者的认知障碍。这项研究调查了患有稀疏新皮质神经炎斑块的人，当他们同时存在脑血管病变时，是否会增加跨过阈值患上临床痴呆症的几率。在1991-1993年火奴鲁鲁-亚洲老龄研究检查期间，对3734名男子进行了痴呆症检查，在1994-1996年检查期间，对2603名男子进行了痴呆症检查。损伤量化是在没有临床数据的情况下进行的。在333名尸检男性中，120人患有痴呆症，115人患有边缘结果，98人认知正常。在患有神经原纤维缠结的男性中，痴呆症的频率随着神经炎斑块密度的增加而增加，并且在存在脑血管病变时进一步增加。这种关联在有稀疏神经性斑块(1-3/mm(2))的男性中最强，其中痴呆症的频率是合并脑血管病变的两倍以上(45%对20%)。在所有痴呆症患者中，24%与脑血管病变有关。研究结果表明，在神经性斑块频率较低的病例中，脑血管病变与明显过量的痴呆症有关。脑血管损伤的预防对于保护晚年的认知功能可能至关重要。
Neocortical neuritic plaques and nettrofibrillary tangles are hallmark neuropathological lesions of dementia. Concomitant cerebrovascular lesions increase dementia severity in patients meeting neuropathological criteria for Alzheimer's disease and contribute to cognitive impairment in persons with mild entorhinal Alzheimer lesions. This study investigates whether individuals with sparse neocortical neuritic plaques experience increased odds of crossing the threshold to clinical dementia when they have coexistent cerebrovascular lesions. Dementia examinations were given to 3,734 men during the 1991-1993 Honolulu-Asia Aging Study examination and to 2,603 men during the 1994-1996 examination. Lesion quantification was done without clinical data. Among 333 autopsied men, 120 had dementia, 115 had marginal results, and 98 had normal cognition. In men with neurofibrillary tangles, dementia frequency increased with increasing neuritic plaque density, and increased further in the presence of cerebrovascular lesions. The association was strongest in men with sparse neuritic plaques (1-3/mm(2)) where dementia frequency more than doubled with coexistent cerebrovascular lesions (45 vs 20%). Among all dementia cases, 24% were linked to cerebrovascular lesions. Findings suggest cerebrovascular lesions are associated with a marked excess of dementia in cases with low neuritic plaque frequency. Prevention of cerebrovascular lesions may be critically important in preserving late-life cognitive function.