March 5, 2021
Abstract
Introduction
The aged brain frequently exhibits multiple pathologies, rather than a single hallmark pathology (pure pathology [PurP]), ranging from low/intermediate levels of additional pathology (LowP) to mixed severe pathology (mixed SevP). We investigated the frequency of PurP, LowP, and mixed SevP, and the impact of additional LowP on cognition.
Methods
Data came from 670 cases from the Brains for Dementia research program. Cases were categorized into PurP, mixed SevP, or a main disease with additional LowP; 508 cases had a clinical dementia rating.
Results
69.9% of cases had LowP, 22.7% had PurP, and 7.5% had mixed SevP. Additional LowP increased the likelihood of having mild dementia versus mild cognitive impairment (MCI) by almost 20‐fold (odds ratio = 19.5).
Discussion
Most aged individuals have multiple brain pathologies. The presence of one additional LowP can significantly worsen cognitive decline, increasing the risk of transitioning from MCI to dementia 20‐fold. Multimorbidity should be considered in dementia research and clinical studies.
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Author: Kirsty E. McAleese,
Sean J. Colloby,
Alan J. Thomas,
Safa Al‐Sarraj,
Olaf Ansorge,
James Neal,
Federico Roncaroli,
Seth Love,
Paul T. Francis,
Johannes Attems
