PATHOLOGICAL MARKERS ASSOCIATED WITH NORMAL AGING AND DEMENTIA IN THEELDERLY

We investigated the associations of pathological markers of Alzheimer' s disease (AD) and diffuse Lewy body disease as well as possible marke rs of vascular dementia with cognitive function in a sample of 20 nond emented and 35 demented subjects (median age of both groups, 88 years) who had been studied prospectively for 4.0 +/- 2.1 years. Very old de mented subjects almost always had nonneuritic senile plaques, but over half had no neuritic senile plaques and little other AD pathology. Fi ve subjects had cortical Lewy bodies; all were demented. We propose th at hippocampal sclerosis, leukoencephalopathy, and multiple lacunae ar e possible markers of vascular dementia. When grouped together, these markers were significantly associated with dementia and occurred in 40 % of demented subjects. As the relative frequency of neuritic markers of AD (and possibly AD itself) declines in the tenth decade, vascular dementia may become an increasingly important type of dementia.