Document Detail


Mild cognitive impairment is related to Alzheimer disease pathology and cerebral infarctions.
MedLine Citation:
PMID:  15753419     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To examine the extent to which persons with mild cognitive impairment have intermediate levels of Alzheimer disease (AD) pathology, cerebral infarcts, and Lewy body disease. METHODS: A total of 180 Catholic clergy participating in the Religious Orders Study underwent annual detailed evaluation and brain autopsy. Blocks of midfrontal, superior temporal, medial temporal lobe, inferior parietal, entorhinal cortex, hippocampus, and substantia nigra were paraffin embedded, and sectioned at 6 mum. Cortical neuritic plaques, diffuse plaques, and neurofibrillary tangles were visualized with Bielschowsky silver stain, and counted and summarized to yield a Braak stage, Consortium to Establish a Registry for Alzheimer's Disease (CERAD) diagnosis, National Institute on Aging (NIA)-Reagan diagnosis, and composite measure of AD pathology. The authors recorded the number and location of all gross chronic cerebral infarctions. Lewy bodies were identified with antibodies to alpha-synuclein. Multiple regression analyses were used to examine the relation of AD pathology and cerebral infarctions to clinical diagnosis proximate to death, controlling for age, sex, and education. RESULTS: A total of 37 had mild cognitive impairment, 60 did not have cognitive impairment, and 83 had dementia proximate to death. Nearly all persons had at least some AD pathology. Cerebral infarctions were present in 35.2%, and 15.6% had Lewy body disease. Persons with mild cognitive impairment were intermediate in terms of Braak stage and CERAD and NIA-Reagan neuropathologic criteria for AD compared to the other two groups. In multiple regression analyses, persons with mild cognitive impairment had intermediate levels of AD pathology from those without cognitive impairment and those with dementia (test for trend, F = 45.2, p < 0.001). Further, the relation between cognition and AD pathology in persons with mild cognitive impairment did not differ significantly from the relation between cognition and AD pathology in persons with dementia or those without cognitive impairment. Persons with mild cognitive impairment also had intermediate levels of cerebral infarctions (test for trend, p = 0.04). Only 3 (8.1%) persons with mild cognitive impairment had Lewy body disease. CONCLUSION: These data suggest that mild cognitive impairment may be the earliest clinical manifestation of common age-related neurologic diseases.
Authors:
D A Bennett; J A Schneider; J L Bienias; D A Evans; R S Wilson
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Neurology     Volume:  64     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-08     Completed Date:  2006-02-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  834-41     Citation Subset:  AIM; IM    
Affiliation:
Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA. dbennett@rush.edu
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Alzheimer Disease / epidemiology,  pathology*,  physiopathology
Brain / blood supply,  pathology*,  physiopathology
Cerebral Infarction / epidemiology,  pathology*,  physiopathology
Cognition Disorders / epidemiology,  pathology*,  psychology
Comorbidity
Disease Progression
Educational Status
Female
Humans
Lewy Bodies / pathology
Lewy Body Disease / epidemiology,  pathology*,  physiopathology
Male
Neurofibrillary Tangles / pathology
Neuropsychological Tests
Senile Plaques / pathology
Sex Factors
Statistics as Topic
Grant Support
ID/Acronym/Agency:
P01AG09466/AG/NIA NIH HHS; P01AG14449/AG/NIA NIH HHS; P30AG10161/AG/NIA NIH HHS; R01AG15819/AG/NIA NIH HHS

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