归因于病理确诊的血管疾病的阿尔茨海默病型痴呆临床诊断事件风险。
Risk of incident clinical diagnosis of Alzheimer's disease-type dementia attributable to pathology-confirmed vascular disease.
作者信息
Dodge Hiroko H, Zhu Jian, Woltjer Randy, Nelson Peter T, Bennett David A, Cairns Nigel J, Fardo David W, Kaye Jeffrey A, Lyons Deniz-Erten, Mattek Nora, Schneider Julie A, Silbert Lisa C, Xiong Chengjie, Yu Lei, Schmitt Frederick A, Kryscio Richard J, Abner Erin L
机构信息
Layton Aging and Alzheimer's Disease Center, Department of Neurology, Oregon Health & Science University, Portland, OR; Michigan Alzheimer's Disease Center, Department of Neurology, University of Michigan, Ann Arbor, MI.
School of Public Health, Department of Biostatistics, University of Michigan, Ann Arbor, MI.
出版信息
Alzheimers Dement. 2017 Jun;13(6):613-623. doi: 10.1016/j.jalz.2016.11.003. Epub 2016 Dec 23.
INTRODUCTION
The presence of cerebrovascular pathology may increase the risk of clinical diagnosis of Alzheimer's disease (AD).
METHODS
We examined excess risk of incident clinical diagnosis of AD (probable and possible AD) posed by the presence of lacunes and large infarcts beyond AD pathology using data from the Statistical Modeling of Aging and Risk of Transition study, a consortium of longitudinal cohort studies with more than 2000 autopsies. We created six mutually exclusive pathology patterns combining three levels of AD pathology (low, moderate, or high AD pathology) and two levels of vascular pathology (without lacunes and large infarcts or with lacunes and/or large infarcts).
RESULTS
The coexistence of lacunes and large infarcts results in higher likelihood of clinical diagnosis of AD only when AD pathology burden is low.
DISCUSSION
Our results reinforce the diagnostic importance of AD pathology in clinical AD. Further harmonization of assessment approaches for vascular pathologies is required.
引言
脑血管病变的存在可能会增加阿尔茨海默病（AD）临床诊断的风险。
方法
我们使用来自衰老与转变风险统计建模研究的数据，研究了腔隙性脑梗死和大面积脑梗死的存在（不包括AD病理）对AD（可能的和疑似的AD）临床诊断的额外风险，该研究是一个包含2000多例尸检的纵向队列研究联盟。我们创建了六种相互排斥的病理模式，将AD病理的三个水平（低、中或高AD病理）和血管病理的两个水平（无腔隙性脑梗死和大面积脑梗死或有腔隙性脑梗死和/或大面积脑梗死）相结合。
结果
仅当AD病理负担较低时，腔隙性脑梗死和大面积脑梗死同时存在会导致AD临床诊断的可能性更高。
讨论
我们的结果强化了AD病理在临床AD诊断中的重要性。需要进一步统一血管病理的评估方法。
Zotero 插件