Risk of incident clinical diagnosis of Alzheimer's disease-type dementia attributable to pathology-confirmed vascular disease

被引：29

作者：

Dodge, Hiroko H. ^{[1
,2
]}

Zhu, Jian ^{[3
]}

Woltjer, Randy ^{[1
]}

Nelson, Peter T. ^{[4
,5
]}

Bennett, David A. ^{[6
,7
]}

Cairns, Nigel J. ^{[8
,9
]}

Fardo, David W. ^{[4
,10
]}

Kaye, Jeffrey A. ^{[1
,11
]}

Lyons, Deniz-Erten ^{[1
,11
]}

Mattek, Nora ^{[1
]}

Schneider, Julie A. ^{[6
,7
,12
]}

Silbert, Lisa C. ^{[1
,11
]}

Xiong, Chengjie ^{[8
]}

Yu, Lei ^{[6
,7
]}

Schmitt, Frederick A. ^{[4
,13
,14
]}

Kryscio, Richard J. ^{[4
,10
]}

Abner, Erin L. ^{[4
,15
]}

机构：

[1] Oregon Hlth & Sci Univ, Dept Neurol, Layton Aging & Alzheimers Dis Ctr, Portland, OR 97201 USA

[2] Univ Michigan, Michigan Alzheimers Dis Ctr, Dept Neurol, Ann Arbor, MI 48109 USA

[3] Univ Michigan, Sch Publ Hlth, Dept Biostat, Ann Arbor, MI 48109 USA

[4] Univ Kentucky, Sanders Brown Ctr Aging, Lexington, KY 40536 USA

[5] Univ Kentucky, Dept Pathol, Lexington, KY USA

[6] Rush Univ, Med Ctr, Rush Alzheimers Dis Ctr, Chicago, IL 60612 USA

[7] Rush Univ, Med Ctr, Dept Neurol Sci, Chicago, IL 60612 USA

[8] Washington Univ, Sch Med, Dept Neurol, Knight Alzheimers Dis Res Ctr, St Louis, MO 63110 USA

[9] Washington Univ, Sch Med, Dept Pathol & Immunol, St Louis, MO USA

[10] Univ Kentucky, Coll Publ Hlth, Dept Biostat, Lexington, KY USA

[11] Portland VA Med Ctr, Portland, OR USA

[12] Rush Univ, Med Ctr, Dept Pathol, Chicago, IL 60612 USA

[13] Univ Kentucky, Coll Med, Dept Neurol, Lexington, KY USA

[14] Univ Kentucky, Dept Psychiat, Lexington, KY USA

[15] Univ Kentucky, Coll Publ Hlth, Dept Epidemiol, Lexington, KY USA

来源：

ALZHEIMERS & DEMENTIA | 2017年 / 13卷 / 06期

关键词：

Alzheimer's disease pathology; Vascular pathology; SMART consortium; Population Attributable Risk%; Community sample; COGNITIVE IMPAIRMENT; NEUROPATHOLOGIC ASSESSMENT; NEUROFIBRILLARY PATHOLOGY; MULTIPLE IMPUTATION; AUTOPSY COHORT; MIXED DEMENTIA; DECLINE; COMMON; AGE; ASSOCIATION;

D O I：

10.1016/j.jalz.2016.11.003

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Introduction: The presence of cerebrovascular pathology may increase the risk of clinical diagnosis of Alzheimer's disease (AD). Methods: 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 Modeling of Aging and Risk of Transition study, a consortium of longitudinal cohort studies with more than 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). Results: The coexistence of lacunes and large infarcts results in higher likelihood of clinical diagnosis of AD only when AD pathology burden is low. Discussion: Our results reinforce the diagnostic importance of AD pathology in clinical AD. Further harmonization of assessment approaches for vascular pathologies is required. (C) 2016 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

引用

页码：613 / 623

页数：11

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