Neuropathologic differences by race from the National Alzheimer's Coordinating Center

Neill R Graff Radford, Lilah M. Besser, Juliana Crook, Walter A. Kukull, Dennis W Dickson

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Introduction Compared to Caucasians, African Americans (AAs) have higher dementia prevalence, different genetic markers, and higher vascular risk factors. However, pathologic underpinnings are unknown. Methods We used neuropathologic and clinical data on 110 AA and 2500 Caucasians who were demented before death. The groups were compared regarding demographics, cognition, apolipoprotein E (APOE) genotype, comorbidities, and clinical and neuropathologic characteristics. Results AA and Caucasians differed in their demographics, cognition at the last visit before death, APOE genotype, presence of hypertension, primary clinical diagnoses, and AD, cerebrovascular disease (CVD), and other neuropathologies such as Lewy body disease (LBD). Discussion AD, LBD, and CVD pathology were more common and TDP and frontotemporal lobar degeneration-tau less common in AA than in Caucasians. APOE accounted for most of the AD neuropathologic differences. If replicated, the observed differences in underlying neuropathology by race will be important for public health policy and recruitment for and interpreting of clinical trials.

Original languageEnglish (US)
Pages (from-to)669-677
Number of pages9
JournalAlzheimer's and Dementia
Volume12
Issue number6
DOIs
StatePublished - Jun 1 2016

Fingerprint

African Americans
Apolipoproteins E
Cerebrovascular Disorders
Lewy Body Disease
Cognition
Genotype
Demography
Frontotemporal Lobar Degeneration
Public Policy
Health Policy
Genetic Markers
Dementia
Comorbidity
Public Health
Clinical Trials
Pathology
Hypertension
Neuropathology

Keywords

  • African American
  • Alzheimer disease
  • Brain autopsy
  • Dementia

ASJC Scopus subject areas

  • Clinical Neurology
  • Developmental Neuroscience
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Epidemiology
  • Health Policy

Cite this

Neuropathologic differences by race from the National Alzheimer's Coordinating Center. / Graff Radford, Neill R; Besser, Lilah M.; Crook, Juliana; Kukull, Walter A.; Dickson, Dennis W.

In: Alzheimer's and Dementia, Vol. 12, No. 6, 01.06.2016, p. 669-677.

Research output: Contribution to journalArticle

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AU - Dickson, Dennis W

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AB - Introduction Compared to Caucasians, African Americans (AAs) have higher dementia prevalence, different genetic markers, and higher vascular risk factors. However, pathologic underpinnings are unknown. Methods We used neuropathologic and clinical data on 110 AA and 2500 Caucasians who were demented before death. The groups were compared regarding demographics, cognition, apolipoprotein E (APOE) genotype, comorbidities, and clinical and neuropathologic characteristics. Results AA and Caucasians differed in their demographics, cognition at the last visit before death, APOE genotype, presence of hypertension, primary clinical diagnoses, and AD, cerebrovascular disease (CVD), and other neuropathologies such as Lewy body disease (LBD). Discussion AD, LBD, and CVD pathology were more common and TDP and frontotemporal lobar degeneration-tau less common in AA than in Caucasians. APOE accounted for most of the AD neuropathologic differences. If replicated, the observed differences in underlying neuropathology by race will be important for public health policy and recruitment for and interpreting of clinical trials.

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