最老年人的边缘主导性与年龄相关的TDP-43脑病变:基于人口的研究
Elizaveta Mikhailenko1, Kia Colangelo1, Jarno Tuimala1
1Department of Pathology, University of Helsinki, 00014 Helsinki, Finland.
Brain : a journal of neurology
|June 28, 2024
概括
临主导的与年龄相关的TDP-43脑病变神经病理变化 (LATE-NC) 在85岁及以上的个体中非常普遍. 这种情况是痴呆症的重要独立预测因素,通常与其他病理共同发生.
科学领域:
- 神经病理学神经病理学
- 老年学是一门学科.
- 流行病学 流行病学
背景情况:
- 基于人口的研究对于了解老年人群中痴呆症的病理基础至关重要.
- 临主导的与年龄相关的TDP-43脑病变神经病理变化 (LATE-NC) 越来越被认可,但在基于人口的环境中未得到充分研究.
- 以前的研究表明LATE-NC的流行率随着年龄的增长而上升.
研究的目的:
- 调查85岁及以上个体LATE-NC的发生频率.
- 检查LATE-NC,其他神经病理和认知功能之间的关联.
- 确定LATE-NC对老年痴呆症的独立贡献.
主要方法:
- 利用基于人口的Vantaa 85+研究队列 (n=601) 进行了对304名受试者的神经病理检查.
- 根据最新的建议,使用TDP-43免疫组织化学评估LATE-NC分期.
- 分析了与阿尔茨海默氏病的神经病理变化 (ADNC),莱维相关病理 (LRP),海马硬化症 (HS),脑粉样血管病变 (CAA),动脉硬化症和认知评分 (MMSE) 的关联.
主要成果:
- 在接受研究的老年人群中,LATE-NC存在于64.1% (189/295).
- 较高的LATE-NC阶段 (1a,2,3) 与痴呆症和较低的MMSE得分有显著的关联.
- 晚期NC经常与ADNC,HS,LRP和动脉样硬化一起发生;它是痴呆症的独立预测因子,在多变量模型中比ADNC具有更高的归因风险.
结论:
- 晚期NC是最老的老年人群中非常常见的一种神经病理发现.
- LATE-NC是晚年痴呆症的重要独立决定因素.
- 该研究强调了LATE-NC在痴呆症病因学中的关键作用,通常与其他病理结合在一起.
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