Mixed pathology is more likely in black than white decedents with Alzheimer dementia
Abstract
Objective:
To compare the burden of neuropathology in black and white participants with clinical Alzheimer disease (AD).
Methods:
Participants included 122 persons enrolled in the Rush Alzheimer's Disease Clinical Core, a prospective cohort study of AD. Forty-one black decedents were matched two-to-one to 81 white decedents according to age at death, sex, years of education, and cognition proximate to death. We examined common brain pathologies related to dementia (AD, Lewy body, and macroscopic and microinfarct pathology) and arteriolar sclerosis and atherosclerosis. We calculated the frequency of each dementia pathology both alone and in combination (mixed pathologies). Racial differences in the odds of a single pathology vs mixed pathologies, and in the odds of vessel disease and its severity, were examined using logistic regression analyses.
Results:
AD pathology was confirmed in >93% of both black and white decedents with AD dementia. However, black decedents were less likely to have Alzheimer pathology as a single dementia pathology than white decedents (19.5% vs 42.0%), and were more likely to have AD mixed with an additional pathology (70.7% vs 50.6%), particularly Alzheimer pathology and Lewy bodies, and Alzheimer pathology, Lewy bodies, and infarcts. Black decedents also had more severe arteriolar sclerosis and atherosclerosis.
Conclusion:
Black decedents with AD dementia are more likely to have mixed brain pathologies compared with age-, sex-, education-, and cognition-matched white decedents with AD dementia.
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Information & Authors
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Copyright
© 2015 American Academy of Neurology.
Publication History
Received: December 23, 2014
Accepted: April 14, 2015
Published online: July 15, 2015
Published in print: August 11, 2015
Disclosure
L. Barnes reports no relevant disclosures for this manuscript. This work was supported in part by NIH grant P30AG10161 and the Illinois Department of Public Health. S. Leurgans reports no relevant disclosures for this manuscript. This work was supported in part by NIH grant P30AG10161 and the Illinois Department of Public Health. N. Aggarwal reports no relevant disclosures for this manuscript. This work was supported by NIH grant P30AG10161. R. Shah reports no relevant disclosures for this manuscript. This work was supported in part by NIH grant P30AG10161 and the Illinois Department of Public Health. Z. Arvanitakis reports no relevant disclosures for this manuscript. This work was supported in part by NIH grants P30AG10161, R01NS084965, and R01AG040039. B. James consults for the Alzheimer's Association and Partners Healthcare. This work was supported by NIH grant P30AG10161. A. Buchman reports no relevant disclosures for this manuscript. This work was supported in part by NIH grants P30AG10161, R01AG043379, and R01NS078009. D. Bennett serves on the editorial board of Neurology®; has received honoraria for non-industry-sponsored lectures; has served as a consultant to Danone, Inc., Wilmar Schwabe GmbH & Co., Eli Lilly, Inc., Schlesinger Associates, and Geson Lehrman Group; and receives research support for NIH grants P30AG010161, R01AG015819, R01AG017917, R01AG036042, U01AG046152, R01AG039478, R01AG040039, R01NS084965, R01AG022018, P20MD006886, R01AG043617, R01NS078009, R01AG036836, R01NS082416, R01AG038651, R01NS086736, R01AG041797, P01AG014449, U18NS082140, U01AG032984, R01AG042210, R01AG043975, and R01AG034119, and research support from Zinfandel. This work was supported in part by NIH grants P30AG10161 and R01AG15819 and the Illinois Department of Public Health. J. Schneider serves on the editorial board of Journal of Neuropathology and Experimental Neurology and Journal of Histochemistry and Cytochemistry and has consulting/advisory relationships with the following companies: AVID Radiopharmaceuticals, Navidea Biopharmaceuticals, Eli Lily Inc., and Genentech USA, and receives research support for NIH grants P30AG010161, R01AG015819, R01AG017917, R01AG042210, R01AG039478, R01AG022018, R01AG036042, and R01AG036836. This work was supported in part by NIH grant P30AG10161 and the Illinois Department of Public Health. Go to Neurology.org for full disclosures.
Study Funding
Supported by NIH grant P30AG10161 and the Illinois Department of Public Health.
Authors
Author Contributions
Lisa L. Barnes: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and final approval, acquisition of data, statistical analysis, study supervision. Sue Leurgans: drafting/revising the manuscript, analysis or interpretation of data, accepts responsibility for conduct of research and final approval, statistical analysis. Neelum T. Aggarwal: drafting/revising the manuscript, study concept or design, accepts responsibility for conduct of research and final approval, acquisition of data, study supervision. Raj C. Shah: drafting/revising the manuscript, analysis or interpretation of data, accepts responsibility for conduct of research and final approval. Zoe Arvanitakis: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and final approval, acquisition of data, obtaining funding. Bryan James: drafting/revising the manuscript, accepts responsibility for conduct of research and final approval. Aron S. Buchman: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and final approval. David A. Bennett: drafting/revising the manuscript, accepts responsibility for conduct of research and final approval, acquisition of data, study supervision, obtaining funding. Julie A. Schneider: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and final approval, acquisition of data, study supervision.
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