What Dementia Looks Like over Age 95

To better define the neuropathology of people over age 95 with and without dementia, a Mayo Clinic team in Jacksonville, FL and Rochester, MN examined results of 137 autopsied patients

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Gamze Balci Camsari, MD and colleagues, in an abstract due to be presented April 21 at the American Academy of Neurology meeting in Washington, DC looked at 71 autopsies of patients who had dementia and 66 who did not.

They found that Alzheimer’s type pathology differed significantly between the groups, though “interestingly the severity of diffuse plaques in the cortex did not differ,” Camsari wrote.

Vascular disease was significantly less common the the non-demented cohort, but the presence of hippocampal sclerosis, Lewy body disease and argyrophilic grains disease did not differ.

Not surprinsgly, the non-demented group had more normal brain tissue and the demented group were more likely to have 3 or more neuropatholgies.

The team’s conclusions were that age, gender and education do not differ significantly in patients with dementia at the time of death and patients who were normal. Subjects with clinical dementia commonly (80%) demonstrate Alzheimer’s pathology and frequently have coexisting neurodegenerative and vascular disease. Those without clinical dementia frequently have a variety of neuropathologic features and only 34% had no plaques.

“In the oldest old, correlation between neuropathological findings and cognitive impairment is imperfect,” they wrote.