National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, Seattle, Washington, USA.
National Institute on Neurological Disease and Stroke, National Institutes of Health, Washington, DC, USA.
Alzheimers Dement. 2024 Jan;20(1):266-277. doi: 10.1002/alz.13422. Epub 2023 Aug 17.
Research-oriented autopsy cohorts provide critical insights into dementia pathobiology. However, different studies sometimes report disparate findings, partially because each study has its own recruitment biases. We hypothesized that a straightforward metric, related to the percentage of research volunteers cognitively normal at recruitment, would predict other inter-cohort differences.
The National Alzheimer's Coordinating Center (NACC) provided data on N = 7178 autopsied participants from 28 individual research centers. Research cohorts were grouped based on the proportion of participants with normal cognition at initial clinical visit.
Cohorts with more participants who were cognitively normal at recruitment contained more individuals who were older, female, had lower frequencies of apolipoprotein E ε4, Lewy body disease, and frontotemporal dementia, but higher rates of cerebrovascular disease. Alzheimer's disease (AD) pathology was little different between groups.
The percentage of participants recruited while cognitively normal predicted differences in findings in autopsy research cohorts. Most differences were in non-AD pathologies.
Systematic differences exist between autopsy cohorts that serve dementia research. We propose a metric to use for gauging a research-oriented autopsy cohort. It is essential to consider the characteristics of autopsy cohorts.
以研究为导向的尸检队列为痴呆症的病理生物学提供了重要的见解。然而，不同的研究有时会报告不同的发现，部分原因是每个研究都有其自身的招募偏倚。我们假设一个简单的指标，与招募时认知正常的研究志愿者的百分比有关，将预测其他队列间的差异。
国家阿尔茨海默病协调中心（NACC）提供了来自 28 个独立研究中心的 7178 名尸检参与者的数据。研究队列是根据初始临床就诊时认知正常的参与者比例进行分组的。
招募时认知正常的参与者比例较高的队列包含更多年龄较大、女性、载脂蛋白 E ε4、路易体病和额颞叶痴呆频率较低、但脑血管疾病发生率较高的个体。阿尔茨海默病（AD）病理在各组之间差异不大。
招募时认知正常的参与者比例预测了尸检研究队列中发现的差异。大多数差异存在于非 AD 病理中。
为痴呆症研究服务的尸检队列存在系统性差异。我们提出了一种用于评估以研究为导向的尸检队列的指标。考虑尸检队列的特征至关重要。
