Neuropathologic differences by race from the National Alzheimer's Coordinating Center.
Compared to Caucasians, African Americans (AAs) have higher dementia prevalence, different genetic markers, and higher vascular risk factors. However, pathologic underpinnings are unknown.



We used neuropathologic and clinical data on 110 AA and 2500 Caucasians who were demented before death. The groups were compared regarding demographics, cognition, apolipoprotein E (APOE) genotype, comorbidities, and clinical and neuropathologic characteristics.



AA and Caucasians differed in their demographics, cognition at the last visit before death, APOE genotype, presence of hypertension, primary clinical diagnoses, and AD, cerebrovascular disease (CVD), and other neuropathologies such as Lewy body disease (LBD).



AD, LBD, and CVD pathology were more common and TDP and frontotemporal lobar degeneration-tau less common in AA than in Caucasians. APOE accounted for most of the AD neuropathologic differences. If replicated, the observed differences in underlying neuropathology by race will be important for public health policy and recruitment for and interpreting of clinical trials.
Department of Neurology, Mayo Clinic, Jacksonville, FL, USA. Electronic address: graffradford.neill@mayo.edu.
Neill R
NR
Graff-Radford
Departments of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; National Alzheimer's Coordinating Center, Seattle, WA, USA.
Lilah M
LM
Besser
Department of Statistics, Mayo Clinic, Jacksonville, FL, USA.
Julia E
JE
Crook
Departments of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; National Alzheimer's Coordinating Center, Seattle, WA, USA.
Walter A
WA
Kukull
Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA.
Dennis W
DW
Dickson
D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology / Q000208:ethnology* / Q000235:genetics / Q000473:pathology*; D001057:Apolipoproteins E / Q000235:genetics; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000453:epidemiology / Q000473:pathology; D008297:Male; D016874:Neurofibrillary Tangles / Q000473:pathology; D014481:United States / Q000453:epidemiology; D044465:White People
D001057:Apolipoproteins E
African American; Alzheimer disease; Brain autopsy; Dementia