Neuropsychology and Neuropathology

A diagnosis of mixed dementia is made when Alzheimer pathology is thought to coexist with second neurodegenerative pathology. It is still unclear how the presence of specific secondary neuropathology interacts with the degree of Alzheimer pathology in determining rate of cognitive and functional decline over time. This information could be helpful in understanding and predicting rate of decline among mixed dementia patients. Methods: Retrospective analyses were conducted on longitudinal data from 498 subjects from the National Alzheimer’s Coordinating Center (NACC) database. At each Braak stage of AD pathology we determined the effect of each secondary neuropathology noted above on patient's neuropsychology profile and rate of functional decline over time on CDR-SB and CDR-Global. Results: We note that Lewy body pathology exhibits significant correlation with functional decline over time in the lower Braak stages(1-2) compared to Vascular disease and Hippocampal sclerosis which exhibit significant correlation with functional decline over time in the higher Braak stages. With Fronto-temporal dementia pathology when present in mixed dementia influencing cognitive and functional decline in both the high and low Braak stages.

This session include further note the neuropsychology profile for some of the mixed neuropathologies could often be distinguished from cases when AD is the primary neuropathology.

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