Challenges of multimorbidity of the aging brain: a critical update
Open accessAbstract
A major problem in elderly patients is the high incidence of multiple pathologies, referred to as multimorbidity, in the aging brain. It has been increasingly recognized that co-occurrence of neurodegenerative proteinopathies and other pathologies including cerebrovascular disorders is a frequent event in the brains of both cognitively intact and impaired aged subjects. Although clinical and neuropathological diagnostic criteria of the major neurodegenerative diseases have been improved, major challenges arise from cerebral multimorbidity, and the thresholds to cause clinical overt dementia are ill defined. More than 80% of aged human brains show neurodegenerative non-Alzheimer type proteinopathies and other pathologies which, however, frequently have been missed clinically and are even difficult to identify at neuropathological examination. Autopsy studies differ in selection criteria and the applied evaluation methods. Therefore, irrespective of the clinical symptoms, the frequency of cerebral pathologies vary considerably: Alzheimer-related pathology is seen in 19-100%, with "pure" Alzheimer's disease (AD) in 17-72%, Lewy pathology in 6-39% (AD + Lewy disease 9-28%), vascular pathologies in 28-93% (10.7-78% "pure" vascular dementia), TDP-43 proteinopathy in 6-39%, hippocampal sclerosis in 8-1%, and mixed pathologies in 10-93%. These data clearly suggest that pathologically deposited proteins in neurodegenerating diseases mutually interact and are influenced by other factor…
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Common age-related neuropathologies, including Alzheimer's disease and other neurodegenerative and cerebrovascular pathologies, are the main causes of dementia, including Alzheimer's dementia.
“Common age-related neuropathologies, including Alzheimer’s disease (AD) and other neurodegenerative and cerebrovascular pathologies, are the main causes of dementia, including Alzheimer’s dementia [31,34].”
From Sex differences in Alzheimer’s disease and common neuropathologies of aging (2018) · cites this paper as [31]
Mixed dementia, not "pure" AD, is the most common cause of dementia in the community.
“Mixed dementia, not “pure” AD, is the most common cause of dementia in the community [31,56].”
From Sex differences in Alzheimer’s disease and common neuropathologies of aging (2018) · cites this paper as [31]
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- Authors
- Jellinger, K. A., & Attems, J.
- Affiliations
- University of Vienna (AT)
- Newcastle University (GB)
- Corresponding author
- Jellinger, Kurt A.
- Venue
- Journal of Neural Transmission
- Published
- 2014-08-05
- Volume
- 122
- Issue
- 4
- Pages
- 505-521
- ISSN
- 0300-9564 (ISSN-L)
- 1435-1463
- OpenAlex
- W2093110422
- Cited by
- 154
- References
- 46
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 15 · 2023: 9 · 2022: 15 · 2021: 8 · 2020: 16 · 2019: 15 · 2018: 14 · 2017: 17 · 2016: 17 · 2015: 8 · 2014: 2
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Neural Transmission (publishedVersion)
- PubMed (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- 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
- brain aging, neurodegenerative proteinopathies, Alzheimer's disease, Lewy body pathology, vascular dementia, TDP-43 proteinopathy, hippocampal sclerosis, cerebrovascular disease, mixed dementia, neuropathology, cognitive decline, biomarkers, dementia diagnosis
- MeSH terms
- Aging, Animals, Brain, Brain Diseases, Humans, Comorbidity
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