Department of Neurology, University of California, Irvine, Irvine, CA 92697-1400, USA.
Curr Alzheimer Res. 2012 Jul;9(6):709-17. doi: 10.2174/156720512801322537.
Population-based longitudinal clinicopathological studies provide an ideal opportunity to study a variety of risk and protective factors in relation to pathology associated with dementia in individuals who are representative of the general population. The 90+ Study is a population-based study designed specifically to study aging and dementia as well as its neuropathological correlates in participants 90 years of age and older. We present demographic and pathological data on the first 104 participants to come to autopsy from the brain donation component of the study, The 90+ Autopsy Study. Cognitive diagnosis was assigned according to diagnostic and statistical manual 4th edition criteria for dementia and neuropathological diagnoses were made according to the Consortium to Establish a Registry for Alzheimer's Disease protocol. Dementia was present in 61% of autopsied participants, the majority of whom were diagnosed with Alzheimer's disease (85%). Many different types of pathology typically associated with dementia were common in the oldest-old, and included neurofibrillary tangles, neuritic plaques, diffuse plaques, Lewy bodies, hippocampal sclerosis, and cerebral infarctions. Most types of pathology were more frequently found in participants suffering from dementia but there was extensive overlap in pathology among those with and without dementia. In addition, 22% of demented participants did not have sufficient pathology to account for their cognitive loss. Our results highlight the poor associations between these common pathological lesions and dementia in the oldest-old and the importance of considering many different types of pathology, possibly including some yet to be identified, in order to account for all dementias in the oldest-old.
基于人群的纵向临床病理研究为研究与痴呆相关的病理相关的各种风险和保护因素提供了理想的机会，这些研究对象是具有代表性的一般人群中的个体。90+ 研究是一项基于人群的研究，旨在专门研究 90 岁及以上参与者的衰老和痴呆及其神经病理学相关性。我们介绍了该研究的脑捐赠部分的前 104 名参与者的人口统计学和病理学数据，该研究称为 90+ 尸检研究。认知诊断根据精神障碍诊断与统计手册第 4 版的痴呆标准进行分配，神经病理学诊断根据阿尔茨海默病研究协会的协议进行。尸检参与者中有 61%患有痴呆症，其中大多数被诊断为阿尔茨海默病（85%）。在最年长的人群中，常见多种与痴呆相关的病理学，包括神经纤维缠结、神经原纤维缠结、弥漫性斑块、路易体、海马硬化和脑梗死。大多数类型的病理学在患有痴呆症的参与者中更为常见，但痴呆症患者和非痴呆症患者之间的病理学有广泛重叠。此外，22%的痴呆症患者的病理学不足以解释其认知丧失。我们的研究结果突出表明，在最年长的人群中，这些常见的病理损伤与痴呆之间的相关性较差，并且需要考虑许多不同类型的病理学，可能包括一些尚未确定的病理学，以解释最年长人群中的所有痴呆症。
