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White matter changes in old age dementia.

M Alexianu1, B Tudorache, E Constantinescu

  • 1Institute of Neurology and Psychiatry, Bucharest, Romania.

Romanian Journal of Neurology and Psychiatry = Revue Roumaine De Neurologie Et Psychiatrie
|July 1, 1991
PubMed
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This study examined brain changes in dementia patients over 60. Myelinic lesions were common, particularly in vascular and mixed dementia, suggesting a role for venous factors in subcortical arteriosclerotic encephalopathy.

Area of Science:

  • Neuropathology
  • Geriatrics
  • Neurodegenerative Diseases

Background:

  • Dementia is a significant health concern in aging populations.
  • Understanding the neuropathological underpinnings of different dementia types is crucial for diagnosis and treatment.
  • Previous studies have highlighted vascular and Alzheimer's pathology, but the role of myelinic changes and venous factors requires further investigation.

Purpose of the Study:

  • To conduct a clinico-morphological study of dementia in patients over 60.
  • To investigate the prevalence and characteristics of neuropathological findings, including myelinic lesions.
  • To explore the potential role of venous factors in the pathogenesis of subcortical arteriosclerotic encephalopathy (SAE).

Main Methods:

  • Clinico-psychometric criteria and the Hachinski scale were used for clinical diagnosis.

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  • Classic neuropathological techniques were employed for macro- and microscopic examination of brain tissue.
  • A cohort of 70 patients aged 60-74 with dementia was analyzed.

    • Main Results:

    • Vascular dementia (VD) was the most common type (33%), followed by Alzheimer-type dementia (ATD) (20%), isolated SAE (17%), and mixed dementia (MD) (14.3%).
    • Myelinic pallor and rarefaction were observed in 41.4% of cases, frequently associated with VD and MD.
    • Edematous lesions and venous congestion were noted in some cases with myelinic changes, particularly those with atherosclerotic vessel wall lesions.

    Conclusions:

    • Myelinic lesions are a significant neuropathological finding in elderly dementia patients, often associated with vascular components.
    • The study suggests a potential role for venous factors in the development of SAE, alongside other etiopathogenic mechanisms.
    • Further research is warranted to elucidate the precise contribution of myelinic and venous pathology to different dementia subtypes.