Neocortical neuritic plaques and neurofibrillary tangles are hallmark neuropa thological lesions of dementia. Concomitant cerebrovascular lesions increase dem entia severity in patients meeting neuropathological crite...Neocortical neuritic plaques and neurofibrillary tangles are hallmark neuropa thological lesions of dementia. Concomitant cerebrovascular lesions increase dem entia severity in patients meeting neuropathological criteria for Alzheimer s disease and contribute to cognitive impairment in persons with mild entorhinal A lzheimer lesions. This study investigates whether individuals with sparse neocor tical neuritic plaques experience increased odds of crossing the threshold to cl inical dementia when they have coexistent cerebrovascular lesions. Dementia exam inations were given to 3,734 men during the 1991- 1993 Honolulu Asia Aging St udy examination and to 2,603 men during the 1994- 1996 examination. Lesion quan tification was done without clinical data. Among 333 autopsied men, 120 had deme ntia, 115 had marginal results, and 98 had normal cognition. In men with neurofi brillary tangles, dementia frequency increased with increasing neuritic plaque d ensity, and increased further in the presence of cerebrovascular lesions. The as sociation was strongest in men with sparse neuritic plaques (1- 3/mm2) where de mentia frequency more than doubled with coexistent cerebrovascular lesions (45 v s 20% ). Among all dementia cases, 24% were linked to cerebrovascular lesions . Findings suggest cerebrovascular lesions are associated with a marked excess o f dementia in cases with low neuritic plaque frequency. Prevention of cerebrovas cular lesions may be critically important in preserving late life cognitive fu nction.展开更多
文摘Neocortical neuritic plaques and neurofibrillary tangles are hallmark neuropa thological lesions of dementia. Concomitant cerebrovascular lesions increase dem entia severity in patients meeting neuropathological criteria for Alzheimer s disease and contribute to cognitive impairment in persons with mild entorhinal A lzheimer lesions. This study investigates whether individuals with sparse neocor tical neuritic plaques experience increased odds of crossing the threshold to cl inical dementia when they have coexistent cerebrovascular lesions. Dementia exam inations were given to 3,734 men during the 1991- 1993 Honolulu Asia Aging St udy examination and to 2,603 men during the 1994- 1996 examination. Lesion quan tification was done without clinical data. Among 333 autopsied men, 120 had deme ntia, 115 had marginal results, and 98 had normal cognition. In men with neurofi brillary tangles, dementia frequency increased with increasing neuritic plaque d ensity, and increased further in the presence of cerebrovascular lesions. The as sociation was strongest in men with sparse neuritic plaques (1- 3/mm2) where de mentia frequency more than doubled with coexistent cerebrovascular lesions (45 v s 20% ). Among all dementia cases, 24% were linked to cerebrovascular lesions . Findings suggest cerebrovascular lesions are associated with a marked excess o f dementia in cases with low neuritic plaque frequency. Prevention of cerebrovas cular lesions may be critically important in preserving late life cognitive fu nction.
