期刊
ALZHEIMER DISEASE & ASSOCIATED DISORDERS
卷 26, 期 3, 页码 205-212出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/WAD.0b013e31822fc24d
关键词
mild cognitive impairment (MCI); epidemiology; neuropathology
资金
- Department of Health
- Joint European Post-Doctoral Programme
- Medical Research Council [MRC.U.1052.00.0013]
- UK NIHR Biomedical Research Centre for Ageing and Age-related disease award
- Medical Research Council [G0502157, G0701539, G0400074, G9901400, MC_U105292687, G1100540, G0900652] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0611-10084] Funding Source: researchfish
- MRC [G0502157, MC_U105292687, G0701539, G1100540, G0400074, G0900652, G9901400] Funding Source: UKRI
Whether the neuropathological profile of mild cognitive impairment (MCI) reflects an intermediate state between normal aging and dementia is not clear. Identifying which phenomena initiate disease and which occur secondary to the neuropathological process is important for targeted disease prevention. Current definitions of MCI include amnestic (aMCI), nonamnestic (nMCI), and multidomain (mMCI) subtypes. In an unbiased population-based cohort of brain donors, we have determined how many individuals fulfill these criteria in the period leading up to death [n= 10 (5 multidomain MCI, 4 amnestic MCI, 1 nonamnestic MCI)]. All MCI cases were collapsed into 1 group and we tested whether their pathologic profile, including markers of Alzheimer disease (AD) and vascular disease (VD), is intermediate to individuals (matched for age, sex, and education) without cognitive impairment (n= 20) or dementia (n= 20). The main findings are of a significant linear trend in the odds of neuritic plaques (entorhinal/hippocampus), atrophy (hippocampal and cortical), infarcts, and small vessel disease (SVD) with increased cognitive impairment. Neuropathologically, MCI is complex, with 10% of MCI brains classified as normal, 10% as VD, 10% as AD, and 40% as mixed AD/VD, with the remaining showing other pathologies. Rather than pure pathologic changes, several different factors seem to contribute to the impairment of MCI. In MCI, both AD and non-AD pathology should be considered as possible intervention targets.
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