title: Clinical dementia rating performed several years prior to death predicts regional Alzheimer's neuropathology.
abstract: OBJECTIVE
  To assess the relationships between early and late antemortem measures of dementia severity and Alzheimer disease (AD) neuropathology severity.
  
  
  METHODS
  40 residents of a nursing home, average age at death 82.0, participated in this longitudinal cohort study with postmortem assessment. Severity of dementia was measured by Clinical Dementia Rating (CDR) at two time points, averaging 4.5 and 1.0 years before death. Densities of postmortem neuritic plaques (NPs) and neurofibrillary tangles (NFTs) were measured in the cerebral cortex, hippocampus, and entorhinal cortex.
  
  
  RESULTS
  For most brain areas, both early and late CDRs were significantly associated with NPs and NFTs. CDRs assessed proximal to death predicted NFTs beyond the contribution of early CDRs. NPs were predicted by both early and late CDRs. NPs were predictive of both early and late CDRs after controlling for NFTs. NFTs were only associated significantly with late CDR in the cerebral cortex after controlling for NPs.
  
  
  CONCLUSIONS
  Even if assessed several years before death, dementia severity is associated with AD neuropathology. NPs are more strongly associated with dementia severity than NFTs. NFTs consistently associate better with late than early CDR, suggesting that these neuropathological changes may occur relatively later in the course of the disease.
authors: Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA. michal.beeri@mssm.edu
authors: Michal
authors: M
authors: Schnaider Beeri
authors: Jeremy M
authors: JM
authors: Silverman
authors: James
authors: J
authors: Schmeidler
authors: Michael
authors: M
authors: Wysocki
authors: Hillel Z
authors: HZ
authors: Grossman
authors: Dushyant P
authors: DP
authors: Purohit
authors: Daniel P
authors: DP
authors: Perl
authors: Vahram
authors: V
authors: Haroutunian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000401:mortality* / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology; D003072:Cognition Disorders / Q000401:mortality* / Q000473:pathology*; D018728:Entorhinal Cortex / Q000473:pathology; D005260:Female; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016874:Neurofibrillary Tangles / Q000473:pathology; D058225:Plaque, Amyloid / Q000473:pathology; D011237:Predictive Value of Tests; D012720:Severity of Illness Index