Alzheimer Disease Pathology in Subjects Without Dementia in 2 Studies of Aging: The Nun Study and the Adult Changes in Thought Study
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Individuals with antemortem preservation of cognition who show autopsy evidence of at least moderate Alzheimer disease (AD) pathology suggest the possibility of brain reserve, that is, functional resistance to structural brain damage. This reserve would, however, only be relevant if the pathologic markers correlate well with dementia. Using data from the Nun Study (n = 498) and the Adult Changes in Thought (ACT) Study (n = 323), we show that Braak staging correlates strongly with dementia status. Moreover, participants with severe(Braak stage V-VI) AD pathology who remained not demented represent only 12% (Nun Study) and 8% (ACT study) of nondemented subjects. Comparison of these subjects to those who were demented revealed that the former group was often significantly memory-impaired despite not being classified as demented. Most of these nondemented participants showed only stage V neurofibrillary pathology and frontal tangle counts that were slightly lower than a comparable (Braak stage V) dementia group. In summary, these data indicate that, in individuals with AD-type pathology who do not meet criteria for dementia, neocortical neurofibrillary tangles are somewhat reduced and incipient cognitive decline is present. Our data provide a foundation for helping to define additional factors that may impair, or be protective of, cognition in older adults.
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The severity and distribution of AD neuropathologic changes are much different (lower) in preclinical cases than in cases with clinically severe ADD.
“Significantly, the severity and distribution of AD neuropathologic changes are much different (lower) in preclinical cases than in cases with clinically severe ADD (48, 108, 148-150).”
From Correlation of Alzheimer Disease Neuropathologic Changes With Cognitive Status: A Review of the Literature (2012) · cites this paper as [149]
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- Authors
- SantaCruz, K. S., Sonnen, J. A., Pezhouh, M. K., Desrosiers, M. F., Nelson, P. T., & Tyas, S. L.
- Affiliations
- University of Minnesota (US)
- Corresponding author
- SantaCruz, Karen S.
- Venue
- Journal of Neuropathology & Experimental Neurology
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-10
- Volume
- 70
- Issue
- 10
- Pages
- 832-840
- ISSN
- 0022-3069 (ISSN-L)
- 1554-6578
- PMC
- PMC3445265
- OpenAlex
- W2075623402
- Cited by
- 79
- References
- 46
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 1 · 2023: 4 · 2022: 5 · 2020: 8 · 2019: 11 · 2018: 6 · 2017: 9 · 2016: 6 · 2015: 7 · 2014: 5 · 2013: 5 · 2012: 6
- FWCI
- 3.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neuropathology & Experimental Neurology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Minnesota
- National Institute on Aging (U01AG006781, R01AG023801, P50AG005136)
- 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 disease pathology, brain reserve, Braak staging, neurofibrillary tangles, dementia, memory impairment, cognitive decline, older adults, Nun Study, Adult Changes in Thought study, neuropathology
- MeSH terms
- Aged, Aged, 80 and over, Aging, Alzheimer Disease, Apolipoproteins E, Brain, Cognition Disorders, Dementia, Female, Humans, Longitudinal Studies, Male, Neuropsychological Tests, Retrospective Studies, Lewy Bodies, Neurofibrillary Tangles, Statistics, Nonparametric
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