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Neurology. 2018 Nov 6;91(19):e1788-e1798. doi: 10.1212/WNL.0000000000006455. Epub 2018 Oct 12.

Risk factors of hippocampal sclerosis in the oldest old: The 90+ Study.

Author information

1
From the College of Medicine (T.T.), The Pennsylvania State University, State College; Departments of Neurology (S.A.S., C.H.K., M.M.C.), Neurobiology and Behavior (C.H.K.), and Epidemiology (M.M.C.), University of California, Irvine; and Department of Pathology, University of Kentucky Sanders-Brown Center on Aging (P.T.N.), University of Kentucky, Lexington.
2
From the College of Medicine (T.T.), The Pennsylvania State University, State College; Departments of Neurology (S.A.S., C.H.K., M.M.C.), Neurobiology and Behavior (C.H.K.), and Epidemiology (M.M.C.), University of California, Irvine; and Department of Pathology, University of Kentucky Sanders-Brown Center on Aging (P.T.N.), University of Kentucky, Lexington. mcorrada@uci.edu.

Abstract

OBJECTIVE:

To examine the risk factors and comorbidities of hippocampal sclerosis (HS) in the oldest-old.

METHODS:

A total of 134 participants with dementia from The 90+ Study with longitudinal evaluations and autopsy were included in this investigation. Participants were divided into 2 groups, one with and one without HS pathology, and differences in clinical and pathologic characteristics were compared.

RESULTS:

Persons with HS tended to have a longer duration of dementia compared to participants without HS (mean 4.0 years vs 6.7 years, odds ratio [OR] 1.26; 95% confidence interval [CI] 1.11-1.42; p < 0.001). HS was more likely in participants with a history of autoimmune diseases (rheumatoid arthritis or thyroid disease, OR 3.15; 95% CI 1.30-7.62; p = 0.011), high thyroid-stimulating hormone (OR 4.94; 95% CI 1.40-17.46; p = 0.013), or high thyroid antibodies (OR 3.45; 95% CI 1.09-10.88; p = 0.035). Lewy body disease (LBD) pathology was also associated with an increased likelihood of HS (OR 5.70; 95% CI 1.22-26.4; p = 0.027).

CONCLUSION:

We identified autoimmune conditions (rheumatoid arthritis and thyroid disease) as potential risk factors for HS in our cohort. LBD was the only pathology that was associated with increased odds of HS and those harboring HS pathology had a longer duration of dementia. This suggests multiple pathways of HS pathology among the oldest-old.

PMID:
30315072
PMCID:
PMC6251605
DOI:
10.1212/WNL.0000000000006455
[Indexed for MEDLINE]
Free PMC Article

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