Premium
P1‐317: QUANTIFICATION OF PATHOLOGICAL LESIONS DETECTS CLINICOPATHOLOGICAL PHENOTYPES OF MIXED AD/LBD
Author(s) -
Walker Lauren,
Thomas Alan J.,
Attems Johannes
Publication year - 2014
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2014.05.558
Subject(s) - pathology , pathological , dementia with lewy bodies , dementia , lewy body , medicine , substantia nigra , disease , hippocampus , alzheimer's disease , parkinson's disease
Background: Alzheimer’s disease (AD) is the main cause of dementia in developed countries and it is estimated that either alone or in combination with cerebral vascular pathology represents over 75%of the etiology of dementias. However, the absence of a consensus system for the neuropathological evaluation of vascular pathology limits classification of cases with mixed pathology and comparability between laboratories. In order to address this issue, we have applied a recently developed system for the assessment of vascular pathology (VPS), together with the classification system of the National Institute on Aging Alzheimer’s Association(NIA) for Alzheimer’s type changes in a series of 50 patients with advanced dementia. Methods: Postmortem neuropathological data were obtained from 50 brains donated to the Tissue Bank of the CIEN Foundation.All subjects were older than 70 years(age 1⁄4 84.88 6 6.13, 70% female, 71% with high school studies), had a diagnosis of m oderate or severe dementia, and had been institutionalized at the Alzheimer Center of Reina Sof ıa Foundation, with regular clinical and cognitive evaluations, before brain donation. Results: The combined use of the NIA and VPS staging allowed a classification of cases into 3 groups:58%Alzheimer’s predominant (AP), 12%, vascular predominant (VP) and 28% mixed pathology (MP). Significant differences were observed in the SMMSE and verbal fluency between the vascular predominant and both other groups of patients. Conclusions: The combination of scales measuring vascular and Alzheimer’s type pathology in postmortem neuropathological evaluation of patients with moderate to advanced dementia allows a classification of cases according to the predominant pathology. This classification reveals significant differences between groups in premortem cognitive outcomes of patients.