Open Peer CommentariesFrequency of Stages of Alzheimer-Related Lesions in Different Age Categories
Section snippets
Materials and Methods
A total of 2,661 brains obtained at autopsy was examined in this study. The brains were collected between 1986 and 1996 and were sent by three Departments of Pathology and one Department of Forensic Pathology belonging to three Universities in Germany. The material included cases from all the affiliated University clinics. It did not originate in special gerontopsychiatric institutions and does not correspond to such preselected material as might have been provided by a Department of
Results
The proportion of cases exhibiting no amyloid deposits or neurofibrillary changes decreases with advancing age (Fig. 2, Fig. 3, upper row). Neither amyloid deposits nor neurofibrillary changes necessarily accompany old age. The evolution of amyloid deposits is shown in Fig. 2 and Table 2. The subpopulations devoid of neurofibrillary changes are represented by the blank areas in the columns in Fig. 2, and the dark areas indicate the subgroups expressing any degree of neurofibrillary changes.
Discussion
The clinical diagnosis of AD is fraught with difficulty and definite diagnoses cannot presently be made. Both false positive and false negative diagnoses occur in a significant proportion of cases, underlining the necessity for postmortem evaluation. Epidemiological studies often focus on avoiding selection bias, yet still face the problem of inaccurate diagnoses 1, 17, 20, 22, 25, 27. Postmortem assessments offer the advantage of unambiguous diagnoses, however, they unavoidably fail to be
Acknowledgements
This study was supported by grants from the Deutsche Forschungsgemeinschaft, the Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie, and Degussa, Hanau. The skillful assistance of Ms. Szasz (drawings) is gratefully acknowledged.
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