Risk of incident clinical diagnosis of Alzheimer's disease-type dementia attributable to pathology-confirmed vascular disease

Hiroko Dodge, Randall (Randy) Woltjer, Jeffrey Kaye, Deniz Erten-Lyons, David A. Bennett, Lisa Silbert, David W. Fardo, Jeffrey A. Kaye, Deniz Erten Lyons, Nora Mattek, Julie A. Schneider, Lisa C. Silbert, Chengjie Xiong, Lei Yu, Frederick A. Schmitt, Richard J. Kryscio, Erin L. Abner

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Introduction: The presence of cerebrovascular pathology may increase the risk of clinical diagnosis of Alzheimer's disease (AD). Methods: We examined excess risk of incident clinical diagnosis of AD (probable and possible AD) posed by the presence of lacunes and large infarcts beyond AD pathology using data from the Statistical Modeling of Aging and Risk of Transition study, a consortium of longitudinal cohort studies with more than 2000 autopsies. We created six mutually exclusive pathology patterns combining three levels of AD pathology (low, moderate, or high AD pathology) and two levels of vascular pathology (without lacunes and large infarcts or with lacunes and/or large infarcts). Results: The coexistence of lacunes and large infarcts results in higher likelihood of clinical diagnosis of AD only when AD pathology burden is low. Discussion: Our results reinforce the diagnostic importance of AD pathology in clinical AD. Further harmonization of assessment approaches for vascular pathologies is required.

Original languageEnglish (US)
JournalAlzheimer's and Dementia
DOIs
StateAccepted/In press - 2016

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Keywords

  • Alzheimer's disease pathology
  • Community sample
  • Population Attributable Risk%
  • SMART consortium
  • Vascular pathology

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Geriatrics and Gerontology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health

Cite this

Dodge, H., Woltjer, R. R., Kaye, J., Erten-Lyons, D., Bennett, D. A., Silbert, L., Fardo, D. W., Kaye, J. A., Lyons, D. E., Mattek, N., Schneider, J. A., Silbert, L. C., Xiong, C., Yu, L., Schmitt, F. A., Kryscio, R. J., & Abner, E. L. (Accepted/In press). Risk of incident clinical diagnosis of Alzheimer's disease-type dementia attributable to pathology-confirmed vascular disease. Alzheimer's and Dementia. https://doi.org/10.1016/j.jalz.2016.11.003