Dementia From Alzheimer Disease and Mixed Pathologies in the Oldest Old

James, Bryan D.

doi:10.1001/jama.2012.3556

Cited by 200Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsNeurological Disease Mechanisms and Treatments

Dementia From Alzheimer Disease and Mixed Pathologies in the Oldest Old

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James, Bryan D.·2012·JAMA

DOI 10.1001/jama.2012.3556PMC PMC3368581

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Abstract

To the Editor: The oldest old (≥90 years of age) are the fastest growing segment of the US population and account for half of all persons with dementia. Alzheimer disease (AD) is the most common pathology underlying dementia in the old (ages 65-89 years). Recent community-based autopsy studies1,2 suggest the relationship between AD pathology and expression of dementia is attenuated in the oldest old.3 Studies may be complicated by the common coexistence of AD plus infarct and/or Lewy body (LB) pathology (mixed pathologies).4 Few data exist on mixed pathologies and dementia in the oldest old.5 We examined the relationship of AD and mixed pathologies to dementia in the oldest old compared with the old. We tested the hypothesis that the clinical expression of AD and mixed pathologies differs across age groups.

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Those age 85 or older are more likely than those younger than 85 to have evidence of two or more causes of dementia.
“For example, those age 85 or older are more likely than those younger than 85 to have evidence of two or more causes of dementia.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [28]
The Results report that mixed pathologies—at least two neuropathologic diagnoses—were more common in the oldest-old group. However, the paper compares people aged 90 or older with those aged 65–89, not people aged 85 or older with those younger than 85. (LLM, conf=0.88)
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Mixed brain pathologies account for most dementia cases in community-dwelling older persons
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Authors: James, B. D.
Affiliations: Rush University Medical Center (US)
Corresponding author: James, Bryan D.
ORCID: James, Bryan D.
Venue: JAMA
Publisher: American Medical Association (AMA)
Published: 2012-05-02
Volume: 307
Issue: 17
Pages: 1798
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.2012.3556
PMC: PMC3368581
OpenAlex: W2015759096
Cited by: 199
References: 5
Citations by year: 2026: 8 · 2025: 5 · 2024: 15 · 2023: 52 · 2022: 15 · 2021: 8 · 2020: 13 · 2019: 14 · 2018: 7 · 2017: 12 · 2016: 15 · 2015: 11 · 2014: 8 · 2013: 16
FWCI: 8.20
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: JAMA (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Aging (R01 AG33678, R01AG017917, P30-AG 10161, P01 AG09466, RC2AG36547, R01-AG34374, R01‐AG17917, R01 AG15819, P01AG014449, R01AG015819, P30AG010161, P01 AG14449, RC2AG036547, P01AG009466, R01AG033678, R01AG034374)
National Institute of Neurological Disorders and Stroke (R01NS028127)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
Keywords: Alzheimer's disease, mixed pathology, dementia, oldest old, Lewy body pathology, cerebral infarction, neuropathology, age differences, autopsy studies
MeSH terms: Age Factors, Aged, Aged, 80 and over, Alzheimer Disease, Cerebral Infarction, Female, Humans, Male, Cohort Studies, Prevalence, Lewy Body Disease

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Dementia From Alzheimer Disease and Mixed Pathologies in the Oldest Old

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