title: Alzheimer neuropathologic alterations in aged cognitively normal subjects.
abstract: The histopathologic changes distinguishing early Alzheimer disease (AD) from normal or pathologic aging are not clearly defined. This report describes the autopsy findings of 59 elderly, well-educated, volunteers. They were examined longitudinally with mental status testing, some for up to 8 years, as part of our normal aging study. This study reveals that (1) the brains of many subjects who did not show cognitive impairment on neuropsychologic testing contain abundant senile plaques (SP) and/or neurofibrillary tangles (NFT); (2) 29 subjects met Khachaturian criteria for AD, 15 met CERAD and 7 met National Institute on Aging-Reagan Institute guidelines; (3) Braak and Braak staging method included 9 in stage IV subjects, 4 in stage V, and 1 in stage VI; (4) there was a progression of NFT from entorhinal cortex to hippocampus and amygdala as a function of age; (5) 2 subjects met criteria for a diagnosis of dementia with Lewy bodies but were not demented; (6) cerebral amyloid angiopathy was present in leptomeningeal vessels in 75% of subjects and in parenchymal vessels in 62% of subjects; (7) only 10 of 59 subjects (17%) had no or few degenerative brain changes. Our study demonstrates that the brains of a large percentage of cognitively normal, relatively well-educated individuals contain numerous degenerative changes and only a small percentage are relatively free of these changes.
authors.affiliation: Sanders-Brown Center on Aging, and Department of Pathology and Laboratory Medicine, University of Kentucky Medical Center, Lexington 40536, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Davis
authors.forename: F A
authors.initials: FA
authors.lastname: Schmitt
authors.forename: D R
authors.initials: DR
authors.lastname: Wekstein
authors.forename: W R
authors.initials: WR
authors.lastname: Markesbery
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology* / Q000502:physiology*; D000544:Alzheimer Disease / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology; D000686:Amyloidosis / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D001057:Apolipoproteins E / Q000235:genetics; D001921:Brain / Q000473:pathology* / Q000502:physiology; D002544:Cerebral Infarction / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D002908:Chronic Disease; D003071:Cognition / Q000502:physiology*; D006259:Craniocerebral Trauma / Q000473:pathology / Q000503:physiopathology; D015140:Dementia, Vascular / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005838:Genotype; D006801:Humans; D016631:Lewy Bodies / Q000473:pathology; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D016874:Neurofibrillary Tangles / Q000473:pathology; D016622:Silver Staining
chemical_list: D001057:Apolipoproteins E