title: Alzheimer's disease neuropathologic change, Lewy body disease, and vascular brain injury in clinic- and community-based samples.
abstract: We examined the relationships between Alzheimer's disease neuropathologic change (ADNC), Lewy body disease (LBD), and vascular brain injury (VBI) in 2 large autopsy samples. Because findings may differ between study populations, data came from U.S. Alzheimer's Disease Centers contributing to the National Alzheimer's Coordinating Center (n = 2742) and from the population-based Adult Changes in Thought study (n = 499). Regardless of study population, over 50% of participants with ADNC had co-occurring LBD or VBI; the majority of whom had a clinical AD dementia diagnosis prior to death. Overlap of pathologies was similar between studies, especially after standardizing to the distribution of age and dementia status in the Adult Changes in Thought population. LBD, but not VBI, was positively associated with ADNC in both studies. Interestingly, cortical LBD was more common in those with intermediate ADNC compared to low or high ADNC, especially in the National Alzheimer's Coordinating Center (p < 0.001). High prevalence of co-occurring neuropathologies among older adults with dementia has implications for accurate diagnosis of dementia etiologies and development of disease-modifying strategies.
authors.affiliation: Department of Epidemiology, University of Washington, Seattle, WA, USA. Electronic address: wbrenow@u.washington.edu.
authors.forename: Willa D
authors.initials: WD
authors.lastname: Brenowitz
authors.affiliation: Department of Pathology, University of Washington, Seattle, WA, USA.
authors.forename: C Dirk
authors.initials: CD
authors.lastname: Keene
authors.affiliation: Department of Epidemiology, University of Washington, Seattle, WA, USA.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Hawes
authors.affiliation: Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Hubbard
authors.affiliation: Department of Epidemiology, University of Washington, Seattle, WA, USA; Department of Neurology, University of Washington, Seattle, WA, USA.
authors.forename: W T
authors.initials: WT
authors.lastname: Longstreth
authors.affiliation: Department of Pathology, Health Sciences University of Oregon, Portland, OR, USA.
authors.forename: Randy L
authors.initials: RL
authors.lastname: Woltjer
authors.affiliation: Department of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Paul K
authors.initials: PK
authors.lastname: Crane
authors.affiliation: Department of Medicine, University of Washington, Seattle, WA, USA; Group Health Research Institute, Seattle, WA, USA.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Larson
authors.affiliation: Department of Epidemiology, University of Washington, Seattle, WA, USA.
authors.forename: Walter A
authors.initials: WA
authors.lastname: Kukull
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology; D000544:Alzheimer Disease / Q000453:epidemiology / Q000473:pathology*; D001344:Autopsy; D001921:Brain / Q000473:pathology*; D020214:Cerebrovascular Trauma / Q000453:epidemiology / Q000473:pathology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000453:epidemiology / Q000473:pathology*; D008297:Male
keywords: Alzheimer's disease; Lewy body disease; Mixed neuropathologies; Older adults; Vascular brain injury