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Cited by 84Dementia and Cognitive Impairment ResearchNeurological Disease Mechanisms and TreatmentsIntracerebral and Subarachnoid Hemorrhage Research

Aging and cerebrovascular lesions in pure and in mixed neurodegenerative and vascular dementia brains: a neuropathological study

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De Reuck, Jacques, Maurage, Claude-Alain, Deramecourt, Vincent, Pasquier, Florence, Cordonnier, Charlotte, Leys, Didier, Bordet, Regis·2018·Folia Neuropathologica
DOI 10.5114/fn.2018.76610
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Abstract

INTRODUCTION: The prevalence of dementia is increasing in our aging population. Because of the complexity of disease pathology, dementia classifications remain controversial. The present post-mortem study investigates whether there are age differences between dementia brains with a single pure neurodegenerative or cerebrovascular disease and those with mixed pathological features. Also, the impact of these vascular lesions is compared. MATERIAL AND METHODS: A total of 132 dementia brains with a pure neurodegenerative or cerebrovascular disease and 84 with mixed features were examined. Main age and gender distribution were compared between the overall group of pure and of mixed dementia. Also, the most common subgroups were compared separately. In addition to the detection of macroscopic visible lesions, a whole coronal section of a cerebral hemisphere, at the level of the mamillary body, was taken for semi-quantitative microscopic evaluation of white matter changes (WMCs), cortical micro-bleeds (CoMBs), and cortical micro-infarcts (CoMIs). RESULTS: Overall, patients with mixed dementia were at death significantly older than those with pure dementia. According to the main diagnosis, the pure forms of Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD) were more common in the younger age groups while in the older ones the mixed form of Lewy body disease (LBD) predominated. Neuropathological examination revealed an increased severity of cerebral amyloid angiopathy (CAA), territorial infarcts, lobar haematomas, and CoMIs in the mixed AD group. In FTLD only CoMIs were increased in the mixed group, while in LBD no differences in severity of all cerebrovascular lesions were observed. Lacunar infarcts were more frequent in pure vascular dementia, while CAA predominated in the mixed one. CONCLUSIONS: Mixed dementia during the aging process is mainly due to the severity of AD and LBD pathologies combined with CAA-related cerebrovascular lesions.

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  • Those age 85 or older are more likely than those younger than 85 to have evidence of two or more causes of dementia.

    “For example, those age 85 or older are more likely than those younger than 85 to have evidence of two or more causes of dementia.”

    From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [27]

    The Results (Table II; page unavailable) show that the oldest-old group made up a larger share of mixed-dementia cases than pure-dementia cases (27% versus 8%), supporting the age-related direction of the claim. Our copy does not define that group as age 85 or older or report a direct comparison of people aged 85 or older with those younger than 85. (LLM, conf=0.84)

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Research works printed but not linked: 7

  1. Brenowitz WD, Keene CD, Hawes SE, Hubbard RA, Londstreth WT Jr, Woltjer RL, Crane PK, Larson EB, Kukull WA. Alzheimer's dis- ease neuropathological change, Lewy body disease and vascular brain injury in clinic-and community-based samples. Neurobiol Aging 2017; 53: 83-92.
  2. De Reuck J, Deramecourt V, Cordonnier C, Leys D, Pasquier F, Maurage CA. Prevalence of cerebrovasular lesions in patients wity Lewy body dementia: a neuropathological study. Clin Neurol Neurosurg 2013; 115: 1094-1097.
  3. Gorelick PB, Scuteri A, Black SE, Decarli C, Greenberg SM, Iade- cola C, Launer LJ, Laurent S, Lopez OL, Nyenhuis D, Petersen RC, Schneider JA, Tzourio C, Arnett DK, Bennett DH, Chui HC, Higashi- da RT, Lindquist R, Nilsson PM, Roman GC, Sellke FW, Seshadri S; American Heart Association Stroke Council, Council on Epidemi- ology and Prevention, Council on Cardiovascular Nursing, Coun- cil on Cardiovascular Radiology and Intervention, and Council on Cardiovascular Surgery and Anesthesia. Vascular contributions to cognitive impairment and dementia: a statement for health- care professionals from the American heart association/Ameri- can stroke association. Stroke 2011; 42: 2672-2713.
  4. Haglund M, Kalaria R, Sladz JY, Englund E. Differential deposition of amyloid beta peptides in cerebral amyloid angiopathy associ- ated with Alzheimer's disease and vascular dementia. Acta Neu- ropathol 2006; 111: 430-435.
  5. Jellinger KA, Attems J. Chalanges of multimorbidity of the aging brain: a critical update. J Neural Transm 2015; 122: 505-5021.
  6. Rahimi J, Kovacs GG. Prevalence of mixed pathology in the aging brain. Alzheimers Res Ther 2014; 6: 82.
  7. Raz L, Koefel J, Bhaskar K. The neuropathology of cerebrovascular mechanisms of dementia. J Cereb Blood Flow Metab 2016; 36: 172-186.

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Authors
De Reuck, J., Maurage, C.-A., Deramecourt, V., Pasquier, F., Cordonnier, C., Leys, D., & Bordet, R.
Affiliations
  • Inserm (FR)
  • Université de Lille (FR)
ORCID
Venue
Folia Neuropathologica
Publisher
Termedia Sp. z.o.o.
Published
2018
Volume
56
Issue
2
Pages
81-87
ISSN
  • 1509-572X (ISSN-L)
  • 1641-4640
DOI
10.5114/fn.2018.76610
OpenAlex
W2883625632
Cited by
84
References
33
Citations by year
2026: 3 · 2025: 6 · 2024: 2 · 2023: 7 · 2022: 12 · 2021: 7 · 2020: 40 · 2019: 6 · 2018: 1
FWCI
10.62
Type
journal article
Language
en
Open access
Licence
cc-by-nc-sa
Locations
  • Folia Neuropathologica (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
  • Health Sciences › Medicine › Neurology › Intracerebral and Subarachnoid Hemorrhage Research
Keywords
mixed dementia, Alzheimer's disease, frontotemporal lobar degeneration, Lewy body disease, cerebral amyloid angiopathy, cerebrovascular lesions, white matter changes, lacunar infarction, aging, age differences, postmortem neuropathology
MeSH terms
Aged, Aged, 80 and over, Aging, Brain, Cerebrovascular Disorders, Dementia, Female, Humans, Male, Neurodegenerative Diseases

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