TY - JOUR
T1 - Contribution of vascular pathology to the clinical expression of dementia
AU - Strozyk, Dorothea
AU - Dickson, Dennis W.
AU - Lipton, Richard B.
AU - Katz, Mindy
AU - Derby, Carol A.
AU - Lee, Sunhee
AU - Wang, Cuiling
AU - Verghese, Joe
N1 - Funding Information:
Funding support : The Einstein Aging Study is funded by the National Institute on Aging (grant AG03949). Dr. Verghese is funded by the National Institute on Aging (RO1 AG025119).
PY - 2010/10
Y1 - 2010/10
N2 - Vascular lesions in the brain are common with advancing age; however, the independent and cumulative contributions of postmortem vascular lesions to antemortem cognitive status are not well established. We examined association of six vascular lesions (large infarcts, lacunar infarcts, leukoencephalopathy, microinfarcts, cribriform changes, and cerebral amyloid angiopathy) with antemortem diagnoses of dementia, Alzheimer's disease (AD), and vascular dementia (VaD) in 190 older adults from an autopsy series. We also developed a summary score based on three macroscopic vascular lesions: large infarcts (0, 1, and ≥2), lacunar infarcts (0, 1, and ≥2), and leukoencephalopathy (none, mild, and moderate-to-severe). Sixty-eight percent of cases had vascular lesions. Only leukoencephalopathy was associated with dementia (odds ratio (OR) 3.5, 95% CI 1.0-12.4), and only large infarcts were associated with VaD (OR 4.3, 95% CI 1.2-15.4). The vascular score was associated with dementia (OR 1.6, 95% CI 1.2-2.3), AD (OR 1.5, 95% CI 1.0-2.1) and VaD (OR 2.0, 95% CI 1.4-3.0). Leukoencephalopathy, large infarcts, and higher vascular burden is associated with the clinical expression of dementia and subtypes.
AB - Vascular lesions in the brain are common with advancing age; however, the independent and cumulative contributions of postmortem vascular lesions to antemortem cognitive status are not well established. We examined association of six vascular lesions (large infarcts, lacunar infarcts, leukoencephalopathy, microinfarcts, cribriform changes, and cerebral amyloid angiopathy) with antemortem diagnoses of dementia, Alzheimer's disease (AD), and vascular dementia (VaD) in 190 older adults from an autopsy series. We also developed a summary score based on three macroscopic vascular lesions: large infarcts (0, 1, and ≥2), lacunar infarcts (0, 1, and ≥2), and leukoencephalopathy (none, mild, and moderate-to-severe). Sixty-eight percent of cases had vascular lesions. Only leukoencephalopathy was associated with dementia (odds ratio (OR) 3.5, 95% CI 1.0-12.4), and only large infarcts were associated with VaD (OR 4.3, 95% CI 1.2-15.4). The vascular score was associated with dementia (OR 1.6, 95% CI 1.2-2.3), AD (OR 1.5, 95% CI 1.0-2.1) and VaD (OR 2.0, 95% CI 1.4-3.0). Leukoencephalopathy, large infarcts, and higher vascular burden is associated with the clinical expression of dementia and subtypes.
KW - Dementia
KW - Pathology
KW - Stroke
KW - Vascular
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U2 - 10.1016/j.neurobiolaging.2008.09.011
DO - 10.1016/j.neurobiolaging.2008.09.011
M3 - Article
C2 - 18996621
AN - SCOPUS:77955843138
SN - 0197-4580
VL - 31
SP - 1710
EP - 1720
JO - Neurobiology of aging
JF - Neurobiology of aging
IS - 10
ER -