Dr. John T MacDonald Foundation Department of Human Genetics, Miller School of Medicine, University of Miami, Miami, Florida, USA.
John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, Florida, USA.
Alzheimers Dement. 2022 Dec;18(12):2403-2412. doi: 10.1002/alz.12516. Epub 2022 Feb 9.
Alzheimer disease (AD) and related dementias are characterized by damage caused by neuropathological lesions in the brain. These include AD lesions (plaques and tangles) and non-AD lesions such as vascular injury or Lewy bodies. We report here an assessment of lesion association to dementia in a large clinic-based population.
We identified 5272 individuals with neuropathological data from the National Alzheimer's Coordinating Center. Individual lesions, as well as a neuropathological composite score (NPCS) were tested for association with dementia, and both functional and neurocognitive impairment using regression models.
Most individuals exhibited mixed pathologies, especially AD lesions in combination with non-AD lesions. All lesion types were associated with one or more clinical outcomes; most even while controlling for AD pathology. The NPCS was also associated with clinical outcomes.
These data suggest mixed-type pathologies are extremely common in a clinic-based population and may contribute to dementia and cognitive impairment.
阿尔茨海默病（AD）和相关痴呆症的特征是大脑中神经病理学损伤引起的损害。这些包括 AD 病变（斑块和缠结）和非 AD 病变，如血管损伤或路易体。我们在此报告了对大型基于诊所人群的病变与痴呆相关性的评估。
我们从国家阿尔茨海默病协调中心确定了 5272 名具有神经病理学数据的个体。使用回归模型测试个体病变以及神经病理学综合评分（NPCS）与痴呆以及功能和神经认知障碍的相关性。
大多数个体表现出混合性病变，特别是 AD 病变与非 AD 病变结合。所有病变类型都与一种或多种临床结局相关；即使在控制 AD 病理学的情况下，大多数病变类型仍然相关。NPCS 也与临床结局相关。
这些数据表明，混合病变在基于诊所的人群中极为常见，可能导致痴呆和认知障碍。
