Identification of normal and pathological aging in prospectively studied nondemented elderly humans
Abstract
Results of a standardized histochemical and immunocytochemical analysis of the brains of 14 nondemented elderly humans for whom prospective neurological and neuropsychological data had been collected for 3 to 8 years before death suggested that nondemented elderly humans fall into two pathological subgroups that are not clinically distinguishable. One was associated with moderate to marked cerebral amyloid deposition ("pathological aging"), while the other had either minimal or no amyloid deposition ("normal aging"). Neocortical and hippocampal neurofibrillary degeneration was either completely absent or of very limited degree in both subgroups. Both subgroups had ubiquitin-immunoreactive dystrophic neurites in the cerebral cortex and granular degeneration of myelin in white matter. These ubiquitin-immunoreactive structures seem to be a universal and invariant manifestation of brain aging, but the same cannot be said for amyloid deposition and neurofibrillary degeneration. Pathological aging might be preclinical Alzheimer's disease, but it currently cannot be distinguished from normal aging by even sensitive neuropsychological measures. These findings provide strong support for the hypothesis that cerebral amyloid deposition is not necessarily associated with clinically apparent cognitive dysfunction and that additional factors, such as neuronal or synaptic loss or widespread cytoskeletal aberrations, are necessary for dementia in AD.
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There is evidence to suggest that neurofibrillary tangles correlate better with cognitive impairment than amyloid deposits.
“There is evidence to suggest that the latter lesions correlate better with cognitive impairment than amyloid deposits [55].”
From The neuropathological diagnosis of Alzheimer's disease (2019) · cites this paper as [55]
Many older neuropsychologically healthy individuals display amyloid deposition.
“many older neuropsychologically healthy individuals display amyloid deposition (145, 146)”
From The Inflammatory Continuum of Traumatic Brain Injury and Alzheimer’s Disease (2018) · cites this paper as [145]
Aβ alone is not predictive of AD.
“Aβ alone is not predictive of AD”
From The Inflammatory Continuum of Traumatic Brain Injury and Alzheimer’s Disease (2018) · cites this paper as [145]
In contrast to previous qualitative observations, the type and number of A deposits were similar in HPC and AD groups.
“In contrast to previous qualitative observations wherein an absence of cored A deposits was suggested to discriminate HPC from AD patients, 3,8 we found the type and number of A deposits to be similar in these groups.”
From Soluble Amyloid β Peptide Concentration as a Predictor of Synaptic Change in Alzheimer's Disease (1999) · cites this paper as [3]
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- Authors
- Dickson, D. W., Crystal, H. A., Mattiace, L. A., Masur, D. M., Blau, A. D., Davies, P., Yen, S.-H., & Aronson, M. K.
- Affiliations
- Albert Einstein College of Medicine (US)
- Corresponding author
- Dickson, Dennis W.
- Venue
- Neurobiology of Aging
- Publisher
- Elsevier BV
- Published
- 1992-01
- Volume
- 13
- Issue
- 1
- Pages
- 179-189
- ISSN
- 0197-4580 (ISSN-L)
- OpenAlex
- W2070137740
- Cited by
- 643
- References
- 53
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 19 · 2023: 14 · 2022: 19 · 2021: 21 · 2020: 17 · 2019: 22 · 2018: 14 · 2017: 13 · 2016: 19 · 2015: 28 · 2014: 22 · 2013: 16 · 2012: 19
- FWCI
- 22.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurobiology of Aging (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p01ns019234-05, 5p01ag006803-11)
- National Institute on Aging (AG-06803, AG03949, P01AG003949)
- National Institute of Neurological Disorders and Stroke (NS-19234)
- 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 › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- normal aging, pathological aging, cerebral amyloid deposition, preclinical Alzheimer's disease, neurofibrillary degeneration, hippocampus, cerebral cortex, dementia, cognitive impairment
- MeSH terms
- Aged, Aged, 80 and over, Aging, Alzheimer Disease, Cerebral Cortex, Female, Frontal Lobe, Hippocampus, Humans, Immunohistochemistry, Male, Memory Disorders, Nerve Degeneration, Prospective Studies, Reference Values, Thiazoles, Ubiquitins, Visual Cortex, Wechsler Scales, Cerebral Amyloid Angiopathy, Neurofibrillary Tangles, Benzothiazoles
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