Academic Journal
Neuropathological diagnoses and clinical correlates in older adults in Brazil: A cross-sectional study.
| العنوان: | Neuropathological diagnoses and clinical correlates in older adults in Brazil: A cross-sectional study. |
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| المؤلفون: | Claudia K Suemoto, Renata E L Ferretti-Rebustini, Roberta D Rodriguez, Renata E P Leite, Luciana Soterio, Sonia M D Brucki, Raphael R Spera, Tarcila M Cippiciani, Jose M Farfel, Alexandre Chiavegatto Filho, Michel Satya Naslavsky, Mayana Zatz, Carlos A Pasqualucci, Wilson Jacob-Filho, Ricardo Nitrini, Lea T Grinberg |
| المصدر: | PLoS Medicine, Vol 14, Iss 3, p e1002267 (2017) |
| بيانات النشر: | Public Library of Science (PLoS) |
| سنة النشر: | 2017 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | Medicine |
| الوصف: | BACKGROUND:Clinicopathological studies are important in determining the brain lesions underlying dementia. Although almost 60% of individuals with dementia live in developing countries, few clinicopathological studies focus on these individuals. We investigated the frequency of neurodegenerative and vascular-related neuropathological lesions in 1,092 Brazilian admixed older adults, their correlation with cognitive and neuropsychiatric symptoms, and the accuracy of dementia subtype diagnosis. METHODS AND FINDINGS:In this cross-sectional study, we describe clinical and neuropathological variables related to cognitive impairment in 1,092 participants (mean age = 74 y, 49% male, 69% white, and mean education = 4 y). Cognitive function was investigated using the Clinical Dementia Rating (CDR) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE); neuropsychiatric symptoms were evaluated using the Neuropsychiatric Inventory (NPI). Associations between neuropathological lesions and cognitive impairment were investigated using ordinal logistic regression. We developed a neuropathological comorbidity (NPC) score and compared it to CDR, IQCODE, and NPI scores. We also described and compared the frequency of neuropathological diagnosis to clinical diagnosis of dementia subtype. Forty-four percent of the sample met criteria for neuropathological diagnosis. Among these participants, 50% had neuropathological diagnoses of Alzheimer disease (AD), and 35% of vascular dementia (VaD). Neurofibrillary tangles (NFTs), hippocampal sclerosis, lacunar infarcts, hyaline atherosclerosis, siderocalcinosis, and Lewy body disease were independently associated with cognitive impairment. Higher NPC scores were associated with worse scores in the CDR sum of boxes (β = 1.33, 95% CI 1.20-1.46), IQCODE (β = 0.14, 95% CI 0.13-0.16), and NPI (β = 1.74, 95% CI = 1.33-2.16). Compared to neuropathological diagnoses, clinical diagnosis had high sensitivity to AD and high specificity to dementia with Lewy body/Parkinson dementia. ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1549-1277 1549-1676 |
| Relation: | http://europepmc.org/articles/PMC5369698?pdf=render; https://doaj.org/toc/1549-1277; https://doaj.org/toc/1549-1676; https://doaj.org/article/b96735f0fc084b65a9266e154e837810 |
| DOI: | 10.1371/journal.pmed.1002267 |
| الاتاحة: | https://doi.org/10.1371/journal.pmed.1002267 https://doaj.org/article/b96735f0fc084b65a9266e154e837810 |
| رقم الانضمام: | edsbas.CE57C45D |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 15491277 15491676 |
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| DOI: | 10.1371/journal.pmed.1002267 |