Portal de Periódicos da CAPES

Artigo Acesso aberto Produção Nacional Revisado por pares

BIBTEX RIS

P1‐215: Etiology of dementia in the different stages of disease: Results from a post‐mortem study

2010; Wiley; Volume: 6; Issue: 4S_Part_8 Linguagem: Inglês

10.1016/j.jalz.2010.05.766

1552-5279

José M. Farfel, Lea T. Grinberg, Renata Elaine Paraízo Leite, Renata Eloah de Lucena Ferretti‐Rebustini, Claudia K.S. Zoriki, Lívia Polichiso, Glaucia Bento, Edilaine Tampelini, Kátia C. Oliveira, Rafael Emidio, Carlos Augusto Pasqualucci, Wilson Jacob Filho, Ricardo Nitríni, Brazilian Aging Brain Study Group,

Dementia and Cognitive Impairment Research

Both vascular dementia and Alzheimer disease are chronic and progressive conditions resulting in cognitive decline. Sometimes it is difficult to distinguish between these two conditions and differences in clinical evolution could help establish an accurate etiological diagnosis. This clinicopathological study aims to analyze the etiology of dementia in individuals who died at different stages of disease. A post-mortem study evaluating individuals, aged 50 years or older, included in the Brain Bank of the Brazilian Aging Brain Study from University of Sao Paulo. Cognitive evaluation was gathered with a semi-structured interview with the next of kin informant using the Clinical Dementia Scale (CDR). Cases were classified as moderate dementia if the CDR = 2 and advanced dementia if the CDR = 3. Neuropathological examinations were carried out based on accepted criteria, using immunohistochemistry. An Alzheimer's disease diagnosis required a Braak stage ≥ IV and moderate or frequent cortical neuritic plaques according to the Consortium to Establish a Registry for Alzheimers Disease (CERAD) criteria. The presence of hyaline atherosclerosis and microinfarcts were registered. Demographical data and cardiovascular risk factors were recorded. From the 122 individuals analyzed, 46 (37.7%) were classified as CDR = 2 and the other 76 individuals (62.3%) had a CDR = 3. The occurrence of a Braak stage ≥ IV (21.7% and 62.7% in CDR 2 and 3, respectively, p < 0,001) and moderate or frequent neuritic plaques according to CERAD (30.2% and 68.1% in CDR 2 and 3, respectively, p < 0,001) was higher in individuals with CDR = 3 and suggested that Alzheimer's disease predominated in patients dying at this stage. A higher prevalence of systemic hypertension (71.7% and 46.1 for CDR 2 and 3, respectively, p = 0,01), heart failure (26.1% and 11.8% for CDR 2 and 3, respectively, p = 0,04) and a trend toward higher prevalence of stroke (45.7% and 30.3% for CDR 2 and 3, respectively, p = 0,08), suggested that vascular disease was more prevalent among individuals dying with a CDR = 2 stage. Individuals suffering from Alzheimer's disease are prone to die at advanced stage of dementia while those who suffer form vascular dementia die at moderate stage of disease.