Title: Alzheimer
1Alzheimers Disease in Centenarians
Clinicopathologic Correlations in the Georgia
Centenarian Study
- Marla Gearing1, William R. Markesbery2, Leonard
W. Poon3, Molly Burgess3, Robert C. Green4 - 1Dept. of Pathology and Laboratory Medicine and
Alzheimers Disease Center, Emory University,
Atlanta, GA 2Dept. of Pathology, University of
Kentucky and Alzheimers Disease Center,
Lexington, KY 3Gerontology Center, University of
Georgia, Athens, GA 4Dept. of Neurology and
Alzheimers Disease Center, Boston University,
Boston, MA
- BACKGROUND
-
- The prevalence of dementia and Alzheimers
disease (AD)
in centenarians is poorly understood. - In studies to date, up to 80 of centenarians
exhibited some cognitive impairment, yet only
40-60 met criteria for dementia or AD. - Few prior studies of centenarians have
included neuropathologic follow-up none have
incorporated both antemortem neuropsychological
testing and postmortem quantitative
neuropathologic assessment measures with
sufficient numbers of subjects to be meaningful.
Neurofibrillary Pathology
Braak score could not be ascertained in one case.
Other Neuropathologic Findings in Centenarians
OBJECTIVE
To report our findings in the first 22 brain
donors enrolled in a project on neuropathology in
centenarians as part of the Georgia Centenarian
Study.
age at evaluation age at death, if deceased,
or current age
RESULTS
Pathology of Centenarians Number of Cases in
Each Neuropathologic Category Stratified by MMSE
Score
- METHODS
-
- Georgia Centenarian Study (GCS)
- In this population-based study, 244 individuals
from 44 counties in Northern Georgia aged 98
years or older were recruited using two sources
1) voter registration lists and date of birth
information, and 2) a census of all skilled
nursing facilities and personal care homes. Each
subject recruited was asked to undergo a series
of interviews, physical examination, blood
drawing, and cognitive testing. The age of each
centenarian was verified by examination of a
birth certificate, drivers license, Medicare
card, or other suitable document.
- CONCLUSIONS
- Findings in the first 22 subjects suggest that
- Pathological findings meeting current
neuropathology diagnostic criteria for AD are
uncommon in centenarians only 4 of our 22 cases
(18) had pathologic changes severe enough to
warrant a neuropathologic diagnosis of AD. - Other pathologic changes or combinations of
changes may contribute to cognitive impairment in
these individuals.
- Neuropathology Project
- 212 individuals were approached about brain
donation. - Sixty-six (31) agreed to undergo additional
cognitive testing at 6-month intervals and donate
their brains at death. Only MMSE scores are
presented here the mean interval between MMSE
and death was 3.0 months (range 0.5 to 6.0
months). - Race and gender of subjects enrolled in the
Neuropathology Project generally parallel those
of subjects enrolled in the Georgia Centenarian
Study.
ACKNOWLEDGMENTS
One case had tiny infarcts in the posterior
pons and in the left CA1-subiculum junction,
insufficient to cause dementia the other case
had a subacute infarct in the parieto-occipital
cortex and Lewy body disease-limbic subtype.
This case had a tiny infarct in the caudate
nucleus. This case had modest numbers of
neuritic plaques and a Braak stage of II.
This study was supported by grant AG17553 from
the National Institute on Aging.