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Alzheimer neuropathologic alterations in aged cognitively normal subjects
D G Davis1, F A Schmitt, D R Wekstein
1Sanders-Brown Center on Aging, and Department of Pathology and Laboratory Medicine, University of Kentucky Medical Center, Lexington 40536, USA.
Journal of Neuropathology and Experimental Neurology
|April 28, 1999
Summary
Many cognitively normal individuals have significant Alzheimer disease (AD) brain changes like senile plaques and neurofibrillary tangles. This suggests current diagnostic criteria may not fully capture early AD pathology in aging brains.
Area of Science:
- Neuropathology
- Neuroscience
- Gerontology
Background:
- Distinguishing early Alzheimer disease (AD) from normal or pathological aging based on histopathology is challenging.
- Longitudinal studies on aging brains are crucial for understanding neurodegenerative changes.
Purpose of the Study:
- To describe autopsy findings in elderly volunteers examined longitudinally.
- To correlate cognitive status with neuropathological changes in aging brains.
Main Methods:
- Autopsy examination of 59 elderly volunteers with longitudinal mental status testing.
- Assessment of neuropathological markers including senile plaques (SP) and neurofibrillary tangles (NFT).
- Application of diagnostic criteria (Khachaturian, CERAD, NIA-Reagan) and Braak staging.
Main Results:
- Many cognitively normal subjects exhibited abundant SP and/or NFT.
- A significant percentage of subjects showed cerebral amyloid angiopathy.
- Only 17% of subjects had minimal or no degenerative brain changes.
Conclusions:
- Cognitively normal, well-educated individuals can have substantial degenerative brain changes.
- Neuropathological findings in aging brains may not always correlate with cognitive impairment.
- Further research is needed to refine diagnostic criteria for early AD.