Mixed pathology is more likely in black than white decedents with Alzheimer dementia
Mixed pathology is more likely in black than white decedents with Alzheimer dementia
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DOI：
10.1212/wnl.0000000000001834
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发表时间：
2015-08-11
期刊：
影响因子：
9.9
通讯作者：
Schneider, Julie A.
中科院分区：
文献类型：
--
作者：
Barnes, Lisa L.;Leurgans, Sue;Schneider, Julie A.
目的：比较黑人和白人受试者与临床阿尔茨海默病(AD)患者的神经病理负担。方法：参加前瞻性队列研究Rush阿尔茨海默病临床核心研究的122人。41名黑人死者与81名白人死者根据死亡时的年龄、性别、受教育年限和接近死亡的认知情况进行了2比1的匹配。我们检查了与痴呆相关的常见脑部病理(阿尔茨海默病、路易小体、宏观和微梗塞病理)以及小动脉硬化和动脉粥样硬化。我们计算了每一种痴呆症病理单独和组合(混合病理)的频率。用Logistic回归分析来检验单一病理与混合病理之间的种族差异，以及血管病变及其严重程度的种族差异。结果：93%的黑人和白人阿尔茨海默病患者都证实了AD病理。然而，与白人死者相比，黑人死者不太可能将阿尔茨海默病作为单一的痴呆病理(19.5%比42.0%)，而更有可能将阿尔茨海默病与其他病理混合(70.7%比50.6%)，特别是阿尔茨海默病和路易体，以及阿尔茨海默氏病、路易体和脑梗塞。结论：与年龄、性别、教育程度和认知能力相匹配的白人阿尔茨海默病患者相比，黑人阿尔茨海默病患者更容易出现混合性脑病理改变。
Objective:To compare the burden of neuropathology in black and white participants with clinical Alzheimer disease (AD).Methods:Participants included 122 persons enrolled in the Rush Alzheimer's Disease Clinical Core, a prospective cohort study of AD. Forty-one black decedents were matched two-to-one to 81 white decedents according to age at death, sex, years of education, and cognition proximate to death. We examined common brain pathologies related to dementia (AD, Lewy body, and macroscopic and microinfarct pathology) and arteriolar sclerosis and atherosclerosis. We calculated the frequency of each dementia pathology both alone and in combination (mixed pathologies). Racial differences in the odds of a single pathology vs mixed pathologies, and in the odds of vessel disease and its severity, were examined using logistic regression analyses.Results:AD pathology was confirmed in >93% of both black and white decedents with AD dementia. However, black decedents were less likely to have Alzheimer pathology as a single dementia pathology than white decedents (19.5% vs 42.0%), and were more likely to have AD mixed with an additional pathology (70.7% vs 50.6%), particularly Alzheimer pathology and Lewy bodies, and Alzheimer pathology, Lewy bodies, and infarcts. Black decedents also had more severe arteriolar sclerosis and atherosclerosis.Conclusion:Black decedents with AD dementia are more likely to have mixed brain pathologies compared with age-, sex-, education-, and cognition-matched white decedents with AD dementia.