Memory and mental status correlates of modified Braak staging

We assessed the relationships of performance on memory and mental status te sts and neuropathologic stage of Alzheimer's disease as defined by Braak an d Braak in 29 patients from a prospective clinicopathologic series. We pred icted that memory changes would occur at an earlier Braak stage than mental status changes. Staging was accomplished by matching the topographic distr ibution of neurofibrillary lesions detected with tau immunocytochemistry to the best fitting diagram published by Braak and Braak. Higher Braak stages were associated with decrements in performance on both memory and mental s tatus tests. As predicted, memory performance declined from stages II to II I and mental status did not decline until stages III to IV. The association between memory and Braak stage was unchanged after adjusting for neocortic al senile plaques, whereas adjustments for Braak stage eliminated the assoc iation between cognitive functioning and amyloid burden. We conclude that B raak staging provides a useful summary of Alzheimer' s disease neuropatholo gy, which is associated with both memory and mental status performance. (C) 2000 Elsevier Science Inc. All rights reserved.