Departments of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.
PLoS One. 2018 Sep 25;13(9):e0204695. doi: 10.1371/journal.pone.0204695. eCollection 2018.
There is strong association of Alzheimer's disease (AD) pathology with gait disorder and falls in older adults without dementia. The goal of the study was to examine the prevalence and severity of AD pathology in older adults without dementia who fall and sustain hip fracture.
Cerebrospinal fluid (CSF) was obtained from 168 hip fracture patients. CSF Aβ42/40 ratio, p-tau, and t-tau measures were dichotomized into normal vs. abnormal, and categorized according to the A/T/N classification.
Among the hip fracture patients, 88.6% of the cognitively normal (Clinical Dementia Rating-CDR 0; n = 70) and 98.8% with mild cognitive impairment (CDR 0.5; n = 81) fell in the abnormal biomarker categories by the A/T/N classification.
A large proportion of older hip fracture patients have CSF evidence of AD pathology. Preoperative determination of AD biomarkers may play a crucial role in identifying persons without dementia who have underlying AD pathology in perioperative settings.
阿尔茨海默病（AD）病理学与步态障碍和无痴呆老年人的跌倒密切相关。本研究的目的是检查无痴呆但跌倒并发生髋部骨折的老年人中 AD 病理学的患病率和严重程度。
从 168 名髋部骨折患者中获取脑脊液（CSF）。将 CSF Aβ42/40 比值、p-tau 和 t-tau 测量值分为正常与异常，并根据 A/T/N 分类进行分类。
在髋部骨折患者中，88.6%的认知正常（临床痴呆评定量表-CDＲ 0；n＝70）和 98.8%的轻度认知障碍（CDＲ 0.5；n＝81）根据 A/T/N 分类落入异常生物标志物类别。
很大一部分老年髋部骨折患者的 CSF 具有 AD 病理学证据。术前确定 AD 生物标志物可能在围手术期识别无痴呆但存在潜在 AD 病理学的患者方面发挥关键作用。
