Neurodegenerative basis of age-related cognitive decline
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OBJECTIVE: To assess the contribution of dementia-related neuropathologic lesions to age-related and disease-related change in cognitive function. METHODS: A total of 354 Catholic nuns, priests, and brothers had annual clinical evaluations for up to 13 years, died, and underwent brain autopsy. The clinical evaluations included detailed testing of cognitive function from which previously established composite measures of global cognition and specific cognitive functions were derived. As part of a uniform neuropathologic evaluation, the density of neurofibrillary tangles was summarized in a composite measure and the presence of Lewy bodies and gross and microscopic cerebral infarction was noted. RESULTS: During follow-up, rate of global cognitive decline was gradual at first and then more than quadrupled in the last 4 to 5 years of life consistent with the onset of progressive dementia. Neurofibrillary tangles, cerebral infarction, and neocortical Lewy bodies all contributed to gradual age-related cognitive decline and little age-related decline was evident in the absence of these lesions. Neurofibrillary tangles and neocortical Lewy bodies contributed to precipitous disease-related cognitive decline, but substantial disease-related decline was evident even in the absence of these lesions. CONCLUSION: Mild age-related decline in cognitive function is mainly due to the neuropathologic lesions traditionally associated with dementia.
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Since the publication of the 2011 NIA-AA guidelines, data have accumulated indicating that cognitive decline in Alzheimer's disease occurs continuously over a long period.
“Since the publication of the 2011 guidelines, data have continued to accumulate indicating that the cognitive decline in AD occurs continuously over a long period [6–8]”
From NIA‐AA Research Framework: Toward a biological definition of Alzheimer's disease (2018) · cites this paper as [7]
The Discussion (Neuropathologic lesions and decline in cognitive systems; page unavailable) links gradual decline before dementia to lesions associated with AD and related disorders. Global cognitive decline reports decline over years that accelerated in the last 52 months of life. The study does not establish that decline occurs continuously in AD specifically: it examined a selected older cohort with multiple kinds of pathology. (LLM, conf=0.82)
Experimental — accuracy not yet measuredEven in extreme old age, the presence of many neocortical NFTs correlates with antemortem cognitive decline.
“Even in extreme old age, the presence of many neocortical NFTs correlates with antemortem cognitive decline (105, 188-191).”
From Correlation of Alzheimer Disease Neuropathologic Changes With Cognitive Status: A Review of the Literature (2012) · cites this paper as [190]
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- DISCLOSURE Dr. Wilson serves as a Consulting Editor for Aging, Neuropsychology, and Cognition and Psychology and Aging; and receives research support from the NIH/NIA (R01AG024871 [principal investigator], P30AG10161 [coin- vestigator], R01AG11101 [coinvestigator], R01AG15819 [coinvesti- gator], R01AG021972 [coinvestigator], U24AG026395 [coinvestigator], R01AG017917 [coinvestigator], R01AG009966 [coinvestigator], and U01AG016979 [coinvestigator]) and the NIH/NIEHS (ES10902 [coinvesti- gator]). Dr. Leurgans receives/has received research support from the NIH (NINDS R01NS28127 [biostatistician], NINDS R01NS40902 [biostat- istician], NIA P01AG009466 [statistics core leader], P30AG010161 [data leader], NIA R01AG024480 [], NIA P01AG014449 [statistics core leader], R01AG033678 [], NIA R01AG017917 [biostatistician]), NIA R01AG024871 [], NIA R01AG22018 [biostatistician], and NIA R01 AG15819 [biostatisti- cian]) and the Michael J. Fox Foundation. Dr. Boyle receives research support from the NIH (R01AG034374 [principal investigator] and R01AG033678 [principal investigator]). Dr. Schneider serves as an Asso- ciate Editor of the Journal of Alzheimer's Disease; serves as a consultant for Avid Radiopharmaceuticals, Inc.; and receives research support from the NIH (R01AG024480 [neuropathologist], P01AG009466 [neuropatholo- gist], P01AG014449 [], R01AG015819 [], R01AG017917 [], R01AG031553 [neuropatholo- gist], R21AG030346 [], R01AG034374 [neuropatholo- gist], R01AG033678 [], R01AG036042 [], RC2AG036547 [], R01HL096944 [neuropathologist], and P30AG010161 [pathology core leader]). Dr. Bennett serves on the editorial board of Neurology ® ; has served as a consultant to Schering-Plough Corp., Medivation, Inc., and the Gerson Lehrman Group; and receives research sup- port from Danone Inc., the NIH (R01AG017917 [principal investigator], R01AG015819 [principal investigator], R01AG036042 [principal investiga- tor], RC2AG036547 [principal investigator], U01AG032984 [co-principal investigator, leader of epidemiologic cohort studies], R01AG024480 [coin- vestigator], R01AG024871 [-Investigator], P01AG009466 [coinvestigator], U24AG026395 [coinvestigator], R01AG030142 [coinvestigator], P01AG01449
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- Authors
- Wilson, R. S., Leurgans, S. E., Boyle, P. A., Schneider, J. A., & Bennett, D. A.
- Affiliations
- Rush University Medical Center (US)
- Venue
- Neurology
- Published
- 2010-09-21
- Volume
- 75
- Issue
- 12
- Pages
- 1070-1078
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC2942064
- OpenAlex
- W2057852669
- Cited by
- 234
- References
- 30
- Citations by year
- 2026: 11 · 2025: 9 · 2024: 12 · 2023: 15 · 2022: 15 · 2021: 32 · 2020: 9 · 2019: 12 · 2018: 11 · 2017: 13 · 2016: 10 · 2015: 12 · 2014: 13 · 2013: 20 · 2012: 26
- FWCI
- 12.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (R01AG015819, P30AG010161, R01AG034374)
- 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
- age-related cognitive decline, dementia, neurofibrillary tangles, Lewy bodies, cerebral infarction, neuropathology, cognitive function, progressive dementia, brain autopsy
- MeSH terms
- Age Factors, Aging, Brain, Cognition, Cognition Disorders, Dementia, Female, Humans, Longitudinal Studies, Male, Nerve Degeneration, Neuropsychological Tests, Lewy Bodies, Neurofibrillary Tangles, Disease Progression
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