Portal de Periódicos da CAPES

Artigo Acesso aberto Produção Nacional Revisado por pares

BIBTEX RIS

O2‐05‐04: Microvascular disease: The difference between preclinical Alzheimer's and dementia

2010; Wiley; Volume: 6; Issue: 4S_Part_4 Linguagem: Inglês

10.1016/j.jalz.2010.05.333

1552-5279

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

Dementia and Cognitive Impairment Research

Cognitively normal elderly may present the same burden and distribution of senile plaques (SP) and neurofibrillary tangles (NFT) found on definitive cases of Alzheimer's disease (AD). Differences in individual characteristics between these groups are yet to be determined and could help explaining why individuals having the same neuropathologic findings can either remain normal or progress to dementia. This study aimed to compare the prevalence of microvascular disease between cognitively normal and demented elderly meeting the neuropathologic criteria for AD. A post-mortem study evaluating individuals, aged 80 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) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Cases were classified as cognitively normal if the CDR = 0 and the IQCODE < 3.20 and as demented if the CDR ≥ 2 and the IQCODE > 3.80. Neuropathological examinations were carried out based on accepted criteria, using immunohistochemistry. All cases presented 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. Microinfarcts were considered relevant when at least 3 areas or strategic areas were affected Demographical data was recorded. From the 59 individuals analyzed, 22 (37.3%) were asymptomatic and the other 37 (62.7%) individuals were demented. All 59 individuals fulfilled neuropathologic criteria for Alzheimer's disease. The presence of microinfarcts was registered in 9.1% and 32.4% of the asymptomatic and demented individuals respectively. (p = 0,04). The difference between the groups remained after adjusting for age, gender and educational level (p = 0,05). A trend of higher prevalence of diffuse hyaline atherosclerosis was observed in the dementia group (18,2% and 41% in the asymptomatic and demented, respectively, p = 0,07). Microinfarcts are more prevalent in AD demented individuals than in cognitively normal elderly harboring AD pathology. The occurrence of microinfarcts may act as a trigger of cognitive decline in individuals with preclinical Alzheimer's disease.