NEUROPATHOLOGICAL DIAGNOSES IN ELDERLY PATIENTS IN OSLO - ALZHEIMERS-DISEASE, LEWY BODY DISEASE, VASCULAR-LESIONS

Neuropathological changes in elderly residents of Oslo, Norway were ch aracterised with respect to the cerebral substrates of dementia. Ninet y-two brains were examined, representing 41% of all deaths occurring i n 10 nursing homes during a 9-month period. The autopsy cohort showed a similar mean age (85 years) and sex ratio (73% female) and proportio n of demented patients (75%) compared to all the patients resident in these homes who died during the same period. Clinical data was compile d retrospectively. Diagnosis was made using the CERAD protocol, and cr iteria for the diagnosis of Lewy body dementia. Lewy body formation wa s present in 20% and cerebral infarction in 21% of patients. In the de mented group (69 patients) 90% fulfilled CERAD criteria for definite o r probable Alzheimer's disease. Eight demented cases had absent neocor tical neurofibrillary tangles and 6 other cases showed Lewy body demen tia (9% of demented patients). A further 8 of these demented cases had brain stem Lewy bodies with only minimal cortical involvement. Thirte en cases (19% of the sample) had cerebral infarcts but these were cons idered to be clinically significant in only 4 (6%). In the non-demente d patients (23) 4 patients had brain stem Lewy bodies and 6 had cerebr al infarcts. Despite inclusion criteria biased towards the collection of Alzheimer's disease and normal patients, both Lewy body dementia (7 %) and cerebral infarcts contributing to dementia (6%) were frequent.