title: Combined Alzheimer's disease and cerebrovascular staging explains advanced dementia cognition.
abstract: BACKGROUND
  The absence of a consensus system for full neuropathological evaluation limits clinicopathological studies and comparability between laboratories. Combined staging for Alzheimer's type and cerebral vascular pathology may allow a better classification of cases for clinical and cognitive correlation.
  
  
  METHODS
  Cognitive and postmortem neuropathological data were obtained from 70 brains donated to the Tissue Bank of the Centro de Investigación de Enfermedades Neurológicas (CIEN) Foundation according to recently developed staging schemes for Alzheimer's type and vascular pathology. Subjects belonged to a cohort of institutionalized patients with moderate or severe dementia and a mean follow-up period of 7 years.
  
  
  RESULTS
  Cases were classified into three groups: Alzheimer's predominant (64.1%), vascular predominant (6.3%) and mixed pathology (29.6%). Significant differences were observed in Severe Mini-Mental State Examination and verbal fluency between the vascular predominant and the other groups of patients.
  
  
  CONCLUSIONS
  The combination of scales measuring cerebral vascular and Alzheimer's type pathology allowed a classification of patients that reveals differences between groups in premortem cognitive features.
authors: Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, Madrid, Spain. Electronic address: mazea@fundaciocien.es.
authors: María Ascensión
authors: MA
authors: Zea-Sevilla
authors: Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, Madrid, Spain.
authors: Miguel Angel
authors: MA
authors: Fernández-Blázquez
authors: Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, Madrid, Spain; Unidad Funcional de Investigación en Enfermedades Crónicas and CIBERNED, Instituto de Salud Carlos III, Madrid, Spain.
authors: Miguel
authors: M
authors: Calero
authors: Hospital Universitario Puerta de Hierro, Neurology Unit, Madrid, Spain.
authors: Pedro
authors: P
authors: Bermejo-Velasco
authors: Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, Madrid, Spain.
authors: Alberto
authors: A
authors: Rábano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology* / Q000523:psychology; D001921:Brain / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000473:pathology* / Q000523:psychology; D003071:Cognition; D003072:Cognition Disorders / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies
keywords: Dementia; NIA; Neuropathological changes; Staging system; Vascular changes