Alzheimer disease pathology and longitudinal cognitive performance in the oldest-old with no dementia

Balasubramanian, Archana B.; Kawas, Claudia H.; Peltz, Carrie; Brookmeyer, Ron; Corrada, María M.

doi:10.1212/wnl.0b013e318266fc77

Cited by 91 publications

(61 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…One such limitation is that cerebrospinal fluid biomarkers of AD were not available [9]. As the relationship between AD pathology and cognition is different in old-old compared to young-old populations [34], it would be of great interest to examine the association between these biomarkers and MCI diagnosed by neuropsychological criteria in very old age. Progression to probable AD based on clinical consensus diagnosis was examined; however, future research would benefit from incorporating autopsy data to confirm AD diagnosis.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Neuropsychological Criteria for Mild Cognitive Impairment in the Framingham Heart Study’s Old-Old

Wong

Thomas

Edmonds

et al. 2018

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

Background/Aims: Mild cognitive impairment (MCI) lacks a “gold standard” operational definition. The Jak/Bondi actuarial neuropsychological criteria for MCI are associated with improved diagnostic stability and prediction of progression to dementia compared to conventional MCI diagnostic approaches, although its utility in diagnosing MCI in old-old individuals (age 75+) is unknown. Therefore, we investigated the applicability of neuropsychological MCI criteria among old-old from the Framingham Heart Study. Methods: A total of 347 adults (ages 79–102) were classified as cognitively normal or MCI via Jak/Bondi and conventional Petersen/Winblad criteria, which differ on cutoffs for cognitive impairment and number of impaired scores required for a diagnosis. Cox models examined MCI status in predicting risk of progression to dementia. Results: MCI diagnosed by both the Jak/Bondi and Petersen/Winblad criteria was associated with incident dementia; however, when both criteria were included in the regression model together, only the Jak/Bondi criteria remained statistically significant. At follow-up, the Jak/Bondi criteria had a lower MCI-to-normal reversion rate than the Petersen/Winblad criteria. Conclusions: Our findings are consistent with previous research on the Jak/Bondi criteria and support the use of a comprehensive neuropsychological diagnostic approach for MCI among old-old individuals.

show abstract

Section: Discussion/conclusionmentioning

confidence: 99%

Neuropsychological Criteria for Mild Cognitive Impairment in the Framingham Heart Study’s Old-Old

Wong

Thomas

Edmonds

et al. 2018

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

show abstract

“…34 Several neuropathology studies suggest an apparent increasing dissociation between dementia and Alzheimer disease pathology, or even any specific pathology, with increasing age. [35][36][37] To address the possibility of limited power to detect small effects in the older group, we stratified the cohort by median onset age to equalize number of incident cases across the groups, and yet found significant risk effects only in the younger group. Nonetheless, our data are based on 67 incident cases detected over 5 years; because overall power can be an issue, we have reported our borderline significant results as well.…”

mentioning

confidence: 99%

Rates and risk factors for progression to incident dementia vary by age in a population cohort

et al. 2015

View full text Add to dashboard Cite

show abstract

“…The observed association of cognitive impairment with increased mortality is attributable to the incapacitating clinical aspects of dementia such as dysphagia and/or malnutrition that can lead to fatal complications (e.g. pneumonia), but also to circulating causes [36,37]. …”

Section: Ad and Placement At A Biological Disadvantagementioning

confidence: 99%

The New Conceptualization of Alzheimer's Disease under the Microscope of Influential Definitions of Disease

Alexopoulos

Kurz

2015

Psychopathology

View full text Add to dashboard Cite

Background: According to its new conceptualization, Alzheimer's disease (AD) has preclinical and symptomatic phases, and biomarker abnormality justifies the diagnosis of the disease. Methods: The conceptual validity of AD is assessed on the basis of the disease definitions of T. Szasz, R.E. Kendell and J.G. Scadding, C. Boorse, K.W.M. Fulford and J.C. Wakefield, as well as of the DSM-5 classification system. Results: The new AD conceptualization could fit the Szaszian disease definition, provided that AD biomarkers reflected the pathological hallmarks of a singular disease, but it seems that they do not. Moreover, preclinical AD does not yield a biological disadvantage, being a central criterion for justifying the presence of a disease according to the disease definition of Scadding and Kendell. In addition, it remains unclear whether abnormality of biomarkers in elderly people embodies a statistical deviation from normal ageing and a pathological characteristic. Furthermore, not all stages of AD are related to experiences of failure of intentional doing, which is the criterion of the disease definition of Fulford, whilst the Wakefieldian harmful dysfunction and the DSM-5 mental disorder criteria are fulfilled only in the symptomatic phases of the disease course. Discussion: Our analytical endeavours unveiled weak sides and the fuzzy boundaries of the new conceptualization of AD. Future refinements of the criteria should address them so that the validity of the AD concept is increased.

show abstract

Alzheimer disease pathology and longitudinal cognitive performance in the oldest-old with no dementia

Cited by 91 publications

References 24 publications

Neuropsychological Criteria for Mild Cognitive Impairment in the Framingham Heart Study’s Old-Old

Neuropsychological Criteria for Mild Cognitive Impairment in the Framingham Heart Study’s Old-Old

Rates and risk factors for progression to incident dementia vary by age in a population cohort

The New Conceptualization of Alzheimer's Disease under the Microscope of Influential Definitions of Disease

Contact Info

Product

Resources

About