非老年人和百岁老人的神经病理负担和痴呆症:比较2个基于社区的队列
Brenna Cholerton1, Caitlin S Latimer1, Paul K Crane1
1From the Department of Pathology (B.C., T.J.M.), Stanford University School of Medicine, CA; Departments of Laboratory Medicine and Pathology (C.S.L., C.D.K.), Medicine (P.K.C.), and General Internal Medicine (L.E.G., E.B.L.), University of Washington, Seattle; Departments of Neurology (M.M.C., C.H.K.), Epidemiology (M.M.C.), and Neurobiology & Behavior (C.H.K.), University of California, Irvine; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle.
神经病理负担和痴呆风险在非常老的成年人中不同. 微血管性脑损伤对年轻老年人的痴呆症的影响更大,而LATE-NC对老年人来说是一个关键目标.
科学领域:
- 神经病理学神经病理学
- 老年学是一门学科.
- 痴呆症研究 痴呆症研究
背景情况:
- 在90岁以上的个体中比较神经病理负担和痴呆症相关性.
- 调查年轻老年人和老年痴呆症病理之间的差异.
- 利用两个大型的临床病理学队列:90+研究和成人思维变化 (ACT) 研究.
研究的目的:
- 为了比较90岁以上的参与者的两个大队伍的神经病理负担.
- 为了确定神经病理负担和痴呆症之间的关联是否与年轻的老年人相比,在最老的成年人中有所不同.
主要方法:
- 评估了90+研究和ACT研究中对痴呆症相关的神经病理变化的验尸参与者.
- 使用逻辑或线性回归评估神经病理变量和痴呆症之间的关联.
- 对神经病理变化的估计加权人口归因分数 (PAF).
主要成果:
- 90+研究队列 (平均年龄97.7) 的粉样蛋白/蛋白负担高于ACT队列 (平均年龄83.5和94.2).
- 在ACT 90+队列中,临界主导的与年龄相关的TDP-43脑病变 (LATE-NC),微血管大脑损伤 (μVBI) 和总神经病理负担的比率更高.
- 微血管脑损伤 (μVBI) 仅在年轻的老年ACT<90组中与痴呆风险相关;LATE-NC的减少可以显著减少90+研究中的痴呆症.
结论:
- 神经病理特征及其痴呆症影响根据队列特征在非老年人和老年人之间有所不同.
- 与老年人相比,微血管病变在年轻人中对痴呆症的影响更大.
- 对于不同的年龄组和人群,需要不同的痴呆症干预措施和疾病特异性生物标志物.
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