Prevalence and pathology of dementia with Lewy bodies in the oldest old: a comparison with other dementing disorders

Dement Geriatr Cogn Disord. 2011;31(4):309-16. doi: 10.1159/000327360. Epub 2011 Apr 20.

Abstract

Background: While the prevalence of Alzheimer disease (AD) increases with age, little is known about the frequency of dementia with Lewy bodies (DLB) in the oldest old. A retrospective hospital-based study compared the relative prevalence of DLB among very old individuals.

Methods: 1,100 consecutive autopsy cases of demented patients aged over 70 years (mean age: 83.9 ± 5.4 years) were examined using standardized neuropathological methods and current diagnostic consensus criteria.

Results: Evaluation of three age groups (8th-10th decade) showed a significant increase in the relative prevalence of AD with cerebrovascular lesions including mixed dementia, while AD with Lewy body (LB) pathology showed a mild but insignificant age-related increase. Both 'pure' AD and vascular dementia showed a mild but insignificant decline, while DLB (without severe AD pathology) decreased progressively. While the severity of Lewy pathology in DLB slightly decreased with age, concomitant Alzheimer-like pathology increased progressively.

Conclusion: Whether DLB in the oldest old represents a distinct group is a matter of discussion, but the relative prevalence of AD with LB in our sample remained fairly stable.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / epidemiology
  • Alzheimer Disease / metabolism
  • Alzheimer Disease / pathology
  • Brain Stem / metabolism
  • Brain Stem / pathology
  • Dementia / epidemiology*
  • Dementia / metabolism
  • Dementia / pathology*
  • Dementia, Vascular / epidemiology
  • Dementia, Vascular / metabolism
  • Dementia, Vascular / pathology
  • Female
  • Humans
  • Lewy Bodies / metabolism
  • Lewy Bodies / pathology*
  • Lewy Body Disease / epidemiology
  • Lewy Body Disease / metabolism
  • Lewy Body Disease / pathology
  • Limbic System / metabolism
  • Limbic System / pathology
  • Male
  • Neocortex / metabolism
  • Neocortex / pathology
  • Prevalence
  • Retrospective Studies
  • alpha-Synuclein / metabolism

Substances

  • alpha-Synuclein