Prevalence of Alzheimer’s disease in very elderly people: A prospective neuropathological study

Polvikoski, T.; Sulkava, R.; Myllykangas, L.; Notkola, I.-L.; Niinistö, L.; Verkkoniemi, A.; Kainulainen, K.; Kontula, K.; Pérez–Tur, J.; Hardy, J.; Haltia, M.

doi:10.1212/wnl.56.12.1690

Cited by 197Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsNeuroinflammation and Neurodegeneration Mechanisms

Prevalence of Alzheimer’s disease in very elderly people: A prospective neuropathological study

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Polvikoski, T., Sulkava, R., Myllykangas, L., Notkola, I.-L., Niinistö, L., Verkkoniemi, A., Kainulainen, K., Kontula, K. +3 more·2001·Neurology

DOI 10.1212/wnl.56.12.1690

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Abstract

BACKGROUND: No previous autopsy-controlled, prospective, and population-based studies are available on the prevalence of AD in very elderly people. OBJECTIVE: To study the point prevalence of neuropathologically defined AD in a population of people at least 85 years of age, stratified according to their APOE genotype. METHODS: A population-based sample of 532 (of a total population of 601) elderly Finnish individuals, aged 85 years or more, were clinically tested for dementia in 1991 (with follow-up studies of the survivors in 1994, 1996, and 1999) and genotyped for APOE. An autopsy involving neuropathologic diagnosis of AD according to modified consensus criteria was performed in 118 of 198 deceased subjects who had been demented on April 1, 1991, and in 62 of 201 nondemented individuals. RESULTS: The prevalence of neuropathologically defined AD was 33%, whereas the prevalence of clinically diagnosed AD was 16%. There was a highly significant (p < 0.001) association between the APOE epsilon4 allele and AD: Sixty-three percent of APOE epsilon4 carriers and 20% of noncarriers had neuropathologic AD. The respective figures in subjects aged 90 years or more were 71 and 22%. CONCLUSIONS: The prevalence of neuropathologically defined AD is higher than that reported in most previous studies based on clinical diagnosis. The discrepancy between the neuropathologic and clinical diagnoses of AD in very elderly subjects may affect the results of population-based studies. The APOE genotype has a strong effect on the prevalence of neuropathologically defined AD, even after 90 years of age.

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“Decades of clinical-pathological correlative studies, now corroborated by a decade of neuroimaging studies, also demonstrate a sizable percentage of the non-demented elderly have plaques [40, 51, 54, 55, 58–68].”
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Authors: Polvikoski, T., Sulkava, R., Myllykangas, L., Notkola, I.-L., Niinistö, L., Verkkoniemi, A., Kainulainen, K., Kontula, K., Pérez–Tur, J., Hardy, J., & Haltia, M.
Affiliations: University of Helsinki (FI)
From the Departments of Pathology (Drs. Polvikoski, Myllykangas, Verkkoniemi, and Haltia), Neurology (Dr. Verkkoniemi), and Medicine (Drs. Kainulainen and Kontula), University of Helsinki and Helsinki University Central Hospital, Finland; Faculty of Social Sciences (Dr. Notkola), University of Helsinki; Department of Public Health and General Practice (Dr. Sulkava), Division of Geriatrics, University of Kuopio and Kuopio University Hospital, Finland; Katriina Geriatric Hospital (Dr. Niinistö),...
ORCID: Myllykangas, L.
Kontula, K.
Hardy, J.
Venue: Neurology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2001-06-26
Volume: 56
Issue: 12
Pages: 1690-1696
ISSN: 0028-3878 (ISSN-L)
1526-632X
DOI: 10.1212/wnl.56.12.1690
OpenAlex: W2060355242
Cited by: 197
References: 41
Citations by year: 2026: 4 · 2025: 6 · 2024: 5 · 2023: 6 · 2022: 4 · 2021: 5 · 2020: 25 · 2019: 6 · 2018: 4 · 2017: 4 · 2016: 7 · 2015: 2 · 2014: 6 · 2013: 10 · 2012: 5
FWCI: 7.90
Type: journal article
Language: en
Open access: green
doi.org
Locations: Neurology (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 › Neuroinflammation and Neurodegeneration Mechanisms
Keywords: Alzheimer's disease, oldest old, prevalence, APOE ε4, APOE genotype, dementia, autopsy
MeSH terms: Aged, Aged, 80 and over, Alzheimer Disease, Apolipoproteins E, Finland, Genotype, Humans, Male, Prospective Studies, Prevalence

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Prevalence of Alzheimer’s disease in very elderly people: A prospective neuropathological study

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