Combined Alzheimer's disease and cerebrovascular staging explains advanced dementia cognition

Alzheimers Dement. 2015 Nov;11(11):1358-66. doi: 10.1016/j.jalz.2015.01.004. Epub 2015 Mar 21.


Introduction: The absence of a consensus system for full neuropathological evaluation limits clinicopathological studies and comparability between laboratories. Combined staging for Alzheimer's type and cerebral vascular pathology may allow a better classification of cases for clinical and cognitive correlation.

Methods: Cognitive and postmortem neuropathological data were obtained from 70 brains donated to the Tissue Bank of the Centro de Investigación de Enfermedades Neurológicas (CIEN) Foundation according to recently developed staging schemes for Alzheimer's type and vascular pathology. Subjects belonged to a cohort of institutionalized patients with moderate or severe dementia and a mean follow-up period of 7 years.

Results: Cases were classified into three groups: Alzheimer's predominant (64.1%), vascular predominant (6.3%) and mixed pathology (29.6%). Significant differences were observed in Severe Mini-Mental State Examination and verbal fluency between the vascular predominant and the other groups of patients.

Discussion: The combination of scales measuring cerebral vascular and Alzheimer's type pathology allowed a classification of patients that reveals differences between groups in premortem cognitive features.

Keywords: Dementia; NIA; Neuropathological changes; Staging system; Vascular changes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / pathology*
  • Alzheimer Disease / psychology
  • Brain / pathology*
  • Cerebrovascular Disorders / pathology*
  • Cerebrovascular Disorders / psychology
  • Cognition Disorders / pathology*
  • Cognition*
  • Female
  • Humans
  • Male
  • Mental Status Schedule
  • Middle Aged
  • Regression Analysis
  • Retrospective Studies