Barnes L L, Schneider J A, Boyle P A, Bienias J L, Bennett D A
Rush Alzheimer's Disease Center, Rush University Medical Center, Armour Academic Facility, 600 S. Paulina, Suite 1038, Chicago, IL 60612, USA.
Neurology. 2006 Nov 14;67(9):1581-5. doi: 10.1212/01.wnl.0000242734.16663.09.
To study the relationship between Alzheimer disease (AD) pathology and memory complaints proximate to death.
A group of 90 older persons underwent detailed clinical evaluations and brain autopsy at death. The evaluations included administration of questions on subjective memory complaints and clinical classification of dementia and AD. On postmortem examination, neuritic plaques, diffuse plaques, and neurofibrillary tangles in tissue samples from five cortical regions were counted, and a summary measure of overall AD pathology was derived. In addition, amyloid load and tau tangles were quantified in eight regions.
In multiple linear regression models adjusted for age, sex, and education, memory complaints were associated with AD pathology, including both amyloid and tau tangles. Subsequent analyses demonstrated that the relationship between memory complaints and AD pathology was present in those with and without dementia, and could not be explained by the potentially confounding effects of depressive symptoms or coexisting common chronic health problems.
Memory complaints in older persons may indicate self awareness of a degenerative process.
研究阿尔茨海默病(AD)病理与临近死亡时记忆障碍之间的关系。
一组90名老年人在死亡时接受了详细的临床评估和脑尸检。评估包括关于主观记忆障碍的问题询问以及痴呆和AD的临床分类。尸检时,对五个皮质区域组织样本中的神经炎性斑块、弥漫性斑块和神经原纤维缠结进行计数,并得出AD总体病理的综合测量值。此外,对八个区域的淀粉样蛋白负荷和tau缠结进行了定量分析。
在根据年龄、性别和教育程度进行调整的多元线性回归模型中,记忆障碍与AD病理相关,包括淀粉样蛋白和tau缠结。后续分析表明,记忆障碍与AD病理之间的关系在患有和未患痴呆症的人群中均存在,且不能用抑郁症状或并存的常见慢性健康问题的潜在混杂效应来解释。
老年人的记忆障碍可能表明其对退行性过程的自我认知。