title: Prevalence and severity of cerebral amyloid angiopathy: a population-based study on very elderly Finns (Vantaa 85+).
abstract: BACKGROUND
  Cerebral amyloid angiopathy (CAA) is frequent in patients with Alzheimer's disease while its prevalence in different populations is variable. We investigated the prevalence and severity of CAA in a very elderly Finnish population.
  
  
  METHODS
  Neuropathological investigation was performed on 306 subjects from the population-based Vantaa 85+ Study (253 women, 53 men, mean age at death 92.3 years). The presence of CAA was analysed in six brain regions by using Congo red and immunohistochemistry with an antibody against amyloid beta peptide. The severity of CAA was assessed by counting the percentage of the CAA-positive blood vessels.
  
  
  RESULTS
  In total, 69.6% of the participants (170 women, 43 men) had CAA, with median severity of 1.0%, inter-quartile range (IQR) 0-5.4% and range 0-72.7%. CAA was more prevalent (81.1% vs. 67.2%; P = 0.046) and severe (median 2.7%, IQR 0.4-7.5%, range 0-72.7%) in the men than in the women (median 1.0%, IQR 0-4.6%, range 0-52.8%; P = 0.004). Parietal lobe showed the highest prevalence (57.8%) whereas the severity was highest (median 1.0%, IQR 0-6.0%, range 0-77%) in the frontal lobe. Prevalence of CAA in the six regions was variable, but the severity indices between those regions correlated highly (P < 0.001 for all regions). Meningeal CAA was more prevalent (69.5%) than cortical (59.3%; P < 0.001).
  
  
  CONCLUSIONS
  CAA was highly prevalent, albeit mild, in the very old. The prevalence and severity of CAA were found to be highest in the frontal and parietal lobes respectively - independent of the staining method used (Congo red or amyloid beta peptide).
authors.affiliation: Department of Pathology, Haartman Institute, University of Helsinki and HUSLAB, Haartmaninkatu 3, Helsinki, Finland. maarit.tanskanen@helsinki.fi
authors.forename: M
authors.initials: M
authors.lastname: Tanskanen
authors.forename: M
authors.initials: M
authors.lastname: Mäkelä
authors.forename: L
authors.initials: L
authors.lastname: Myllykangas
authors.forename: I-L
authors.initials: IL
authors.lastname: Notkola
authors.forename: T
authors.initials: T
authors.lastname: Polvikoski
authors.forename: R
authors.initials: R
authors.lastname: Sulkava
authors.forename: H
authors.initials: H
authors.lastname: Kalimo
authors.forename: A
authors.initials: A
authors.lastname: Paetau
mesh_terms: D000369:Aged, 80 and over; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D016657:Cerebral Amyloid Angiopathy / Q000453:epidemiology* / Q000473:pathology*; D004396:Coloring Agents; D003224:Congo Red; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D015995:Prevalence
chemical_list: D004396:Coloring Agents; D003224:Congo Red