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Published on: December 18, 2016
Neuropathologic correlates of cognition in a population-based sample.
Brenna Cholerton1, Eric B Larson, Laura D Baker
1Geriatric Research, Education, & Clinical Center, Veterans Affairs Puget Sound Health Care System, 9600 Veterans Drive SW, Tacoma, WA 98493, USA. bchol@u.washington.edu
Journal of Alzheimer'S Disease : JAD
|May 14, 2013
Summary
Neuropathologic changes, including Alzheimer's disease (AD), Lewy body disease (LBD), and vascular brain injury (VBI), are linked to cognitive decline in older adults. These brain pathologies impact memory, executive function, and visuospatial skills, even in non-demented individuals.
Area of Science:
- Neuropathology
- Cognitive Neuroscience
- Gerontology
Background:
- Many cognitively normal older adults exhibit underlying neuropathologic changes associated with increased dementia risk.
- Alzheimer's disease (AD), vascular brain injury (VBI), and Lewy body disease (LBD) are common neuropathologies in aging brains.
- Understanding the relationship between these pathologies and cognitive function is crucial for early detection and intervention.
Purpose of the Study:
- To investigate the association between multiple neuropathologic indices and performance on specific cognitive domains in a community-based sample of older adults.
- To determine if neuropathologic lesions contribute to cognitive impairment beyond established Alzheimer's disease changes.
- To explore the differential impact of various neuropathologies on distinct cognitive functions.
Main Methods:
- Analysis of autopsy data from 363 participants of the Adult Changes in Thought study with prior cognitive testing.
- Assessment of neuropathologic endpoints including AD changes, LBD, cerebral amyloid angiopathy, and VBI (microvascular lesions, μVBI).
- Correlation of Cognitive Abilities Screening Instrument (CASI) scores with neuropathologic findings using regression analyses.
Main Results:
- Braak stage for neurofibrillary tangles, lower brain weight, and cerebral cortical microvascular lesions (μVBI) significantly predicted global cognitive performance (R2 = 0.31).
- These neuropathologies explained cognitive variance even in non-demented subjects (R2 = 0.23).
- Specific cognitive domains showed differential associations: memory/executive function with AD pathology and cortical μVBI; executive function with subcortical μVBI; visuospatial skills with LBD.
Conclusions:
- Neuropathologic lesions from Lewy body disease and microvascular VBI are associated with poorer cognitive performance, independent of Alzheimer's disease pathology.
- Cognitive impairment in older adults is a complex trait resulting from the convergence of multiple neuropathologic factors.
- These findings have significant implications for the clinical investigation and medical management of cognitive aging and dementia risk.
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