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Neurobiol Aging. 2019 May;77:26-36. doi: 10.1016/j.neurobiolaging.2019.01.008. Epub 2019 Jan 21.

The influence of tau, amyloid, alpha-synuclein, TDP-43, and vascular pathology in clinically normal elderly individuals.

Author information

1
Department of Neurology, Mayo Clinic, Rochester, MN, USA.
2
Department of Radiology, Mayo Clinic, Rochester, MN, USA.
3
Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
4
Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA.
5
Department of Psychology (Neuropsychiatry), Mayo Clinic, Rochester, MN, USA.
6
Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Mayo Clinic, Rochester, MN, USA.
7
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
8
Department of Neurology, Mayo Clinic, Rochester, MN, USA. Electronic address: josephs.keith@mayo.edu.

Abstract

Many individuals live to older ages without clinical impairment. It is unknown whether brain pathologies in these individuals are associated with subtle clinical deficits. We analyzed the brains of 161 clinically normal (Clinical Dementia Rating score = 0) older individuals enrolled in the Mayo Clinic Patient Registry or Study of Aging. We assessed for the presence and burden of beta-amyloid, tau, alpha-synuclein, TDP-43, and vascular pathology. We investigated whether pathologies were associated with antemortem cognitive and motor function, depression, MRI volumetric measures, or the apolipoprotein E (APOE) ε4 allele. Eighty-six percent had at least 1 pathology, and 63% had mixed pathologies. Tau and vascular pathology were associated with poorer memory scores. Tau was also associated with poorer general cognition scores and smaller amygdala, hippocampi, and entorhinal cortex volumes. Beta-amyloid neuritic plaque burden was associated with greater depression scores. The presence of a greater number of pathologies was associated with APOE e4 carrier status and with poorer memory performance. Some dementia-related pathologies are associated with poorer performance in clinical measures and brain atrophy in the unimpaired elderly.

KEYWORDS:

Brain volume; Clinically normal aging; Cognition; Depression; Neurodegenerative pathology; TDP-43; Vascular pathology

PMID:
30776649
PMCID:
PMC6486870
[Available on 2020-05-01]
DOI:
10.1016/j.neurobiolaging.2019.01.008

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