Alzheimer's disease neuropathologic change, Lewy body disease, and vascular brain injury in clinic- and community-based samples

Willa D. Brenowitz, C. Dirk Keene, Stephen E. Hawes, Rebecca A. Hubbard, W. T. Longstreth, Randy L. Woltjer, Paul K. Crane, Eric B. Larson, Walter A. Kukull

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

We examined the relationships between Alzheimer's disease neuropathologic change (ADNC), Lewy body disease (LBD), and vascular brain injury (VBI) in 2 large autopsy samples. Because findings may differ between study populations, data came from U.S. Alzheimer's Disease Centers contributing to the National Alzheimer's Coordinating Center (n = 2742) and from the population-based Adult Changes in Thought study (n = 499). Regardless of study population, over 50% of participants with ADNC had co-occurring LBD or VBI; the majority of whom had a clinical AD dementia diagnosis prior to death. Overlap of pathologies was similar between studies, especially after standardizing to the distribution of age and dementia status in the Adult Changes in Thought population. LBD, but not VBI, was positively associated with ADNC in both studies. Interestingly, cortical LBD was more common in those with intermediate ADNC compared to low or high ADNC, especially in the National Alzheimer's Coordinating Center (p < 0.001). High prevalence of co-occurring neuropathologies among older adults with dementia has implications for accurate diagnosis of dementia etiologies and development of disease-modifying strategies.

Original languageEnglish (US)
Pages (from-to)83-92
Number of pages10
JournalNeurobiology of Aging
Volume53
DOIs
StatePublished - May 1 2017

Keywords

  • Alzheimer's disease
  • Lewy body disease
  • Mixed neuropathologies
  • Older adults
  • Vascular brain injury

ASJC Scopus subject areas

  • General Neuroscience
  • Aging
  • Clinical Neurology
  • Developmental Biology
  • Geriatrics and Gerontology

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