Abstract
Introduction: Whether co-occurring neuropathologies interact or independently affect clinical disease progression is uncertain. We estimated rates of clinical progression and tested whether associations between clinical progression and Alzheimer's disease neuropathology (ADNP) were modified by co-occurring Lewy body disease (LBD) or vascular brain injury (VBI). Methods: Linear mixed effects models evaluated longitudinal trends in the Clinical Dementia Rating Scale Sum of Boxes on 2046 autopsied participants seen at a U.S. Alzheimer's Disease Center. Results: Annual clinical progression was slightly faster for ADNP + LBD compared with ADNP only (P = .06) and slightly slower for ADNP + VBI (P = .003). Differences in progression were less than expected if each neuropathology independently contributed to progression; ADNP interacted with LBD (P = .002) and VBI (P = .003). In secondary models, the effect of additional pathologies on clinical progression was greater in those with intermediate compared with high levels of ADNP. Discussion: The impact of co-occurring pathologies on progression may depend on severity of ADNP.
| Original language | English (US) |
|---|---|
| Journal | Alzheimer's and Dementia |
| DOIs | |
| State | Accepted/In press - 2016 |
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Keywords
- Alzheimer's disease neuropathology
- Cerebrovascular disease
- Clinical progression
- Lewy body disease
- Mixed neuropathology
ASJC Scopus subject areas
- Epidemiology
- Health Policy
- Developmental Neuroscience
- Geriatrics and Gerontology
- Clinical Neurology
- Cellular and Molecular Neuroscience
- Psychiatry and Mental health
Cite this
Mixed neuropathologies and estimated rates of clinical progression in a large autopsy sample. / Brenowitz, Willa D.; Hubbard, Rebecca A.; Keene, C. Dirk; Hawes, Stephen E.; Longstreth, W. T.; Woltjer, Randall (Randy); Kukull, Walter A.
In: Alzheimer's and Dementia, 2016.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Mixed neuropathologies and estimated rates of clinical progression in a large autopsy sample
AU - Brenowitz, Willa D.
AU - Hubbard, Rebecca A.
AU - Keene, C. Dirk
AU - Hawes, Stephen E.
AU - Longstreth, W. T.
AU - Woltjer, Randall (Randy)
AU - Kukull, Walter A.
PY - 2016
Y1 - 2016
N2 - Introduction: Whether co-occurring neuropathologies interact or independently affect clinical disease progression is uncertain. We estimated rates of clinical progression and tested whether associations between clinical progression and Alzheimer's disease neuropathology (ADNP) were modified by co-occurring Lewy body disease (LBD) or vascular brain injury (VBI). Methods: Linear mixed effects models evaluated longitudinal trends in the Clinical Dementia Rating Scale Sum of Boxes on 2046 autopsied participants seen at a U.S. Alzheimer's Disease Center. Results: Annual clinical progression was slightly faster for ADNP + LBD compared with ADNP only (P = .06) and slightly slower for ADNP + VBI (P = .003). Differences in progression were less than expected if each neuropathology independently contributed to progression; ADNP interacted with LBD (P = .002) and VBI (P = .003). In secondary models, the effect of additional pathologies on clinical progression was greater in those with intermediate compared with high levels of ADNP. Discussion: The impact of co-occurring pathologies on progression may depend on severity of ADNP.
AB - Introduction: Whether co-occurring neuropathologies interact or independently affect clinical disease progression is uncertain. We estimated rates of clinical progression and tested whether associations between clinical progression and Alzheimer's disease neuropathology (ADNP) were modified by co-occurring Lewy body disease (LBD) or vascular brain injury (VBI). Methods: Linear mixed effects models evaluated longitudinal trends in the Clinical Dementia Rating Scale Sum of Boxes on 2046 autopsied participants seen at a U.S. Alzheimer's Disease Center. Results: Annual clinical progression was slightly faster for ADNP + LBD compared with ADNP only (P = .06) and slightly slower for ADNP + VBI (P = .003). Differences in progression were less than expected if each neuropathology independently contributed to progression; ADNP interacted with LBD (P = .002) and VBI (P = .003). In secondary models, the effect of additional pathologies on clinical progression was greater in those with intermediate compared with high levels of ADNP. Discussion: The impact of co-occurring pathologies on progression may depend on severity of ADNP.
KW - Alzheimer's disease neuropathology
KW - Cerebrovascular disease
KW - Clinical progression
KW - Lewy body disease
KW - Mixed neuropathology
UR - http://www.scopus.com/inward/record.url?scp=85008599124&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85008599124&partnerID=8YFLogxK
U2 - 10.1016/j.jalz.2016.09.015
DO - 10.1016/j.jalz.2016.09.015
M3 - Article
JO - Alzheimer's and Dementia
JF - Alzheimer's and Dementia
SN - 1552-5260
ER -