High Prevalence of Co-Morbidity in Pathologically Confirmed Alzheimer Disease in a Canadian Regional Brain Biobank (P6.221)
Bibliographic record
Abstract
Objective: To define the prevalence and association with age of co-morbid neurodegenerative and vascular diseases in pathologically confirmed Alzheimer Disease (AD). Background Recent studies suggest that co-existent neurodegenerative and/or vascular pathologies are the rule rather than the exception in AD. The underlying drivers of co-morbidity in AD remain unclear. Methods This study was conducted at a provincial neuropathology referral centre in Vancouver, British Columbia. Primary and contributory etiologic diagnoses were recorded for all brain autopsies performed by a single experienced neuropathologist between December 1997 and January 2015. Consensus neuropathologic criteria were used where available to define AD, Cerebrovascular Disease (CVD), Dementia with Lewy Bodies (DLB), Frontotemporal Lobar Degeneration (FTLD), Corticobasal Degeneration (CBD), Progressive Supranuclear Palsy (PSP), and Hippocampal Sclerosis (HS). Results 147 cases of NIA/Reagan criteria-defined AD were identified. AD coexisted with CVD (defined as moderate or severe arteriosclerosis or moderate or severe cerebral amyloid angiopathy or presence of lacunar cerebral infarction or large artery-related cerebral infarction or hemorrhagic cerebral infarction) in 78.9[percnt] (116/147), moderate or severe cerebral amyloid angiopathy in 39.5[percnt] (58/147), moderate or severe arteriosclerosis in 70.7[percnt] (104/147), DLB in 26.5[percnt] (39/147), FTLD in 2[percnt] (3/147), CBD in 2[percnt] (3/147), PSP in 0.7[percnt] (1/147), and HS in 6.8[percnt]. 27.2[percnt] (40/147) had 2 or more pathologies in addition to AD. Those with additional pathologies were older than cases with AD alone (77.7 (+/- SD 9.8) yrs vs. 70.0 (+/- 8.4) yrs, p=0.002). Older age was associated with increasing number of additional pathologies (spearman rho= 0.29, p=0.004). Conclusion Multi-morbidity is a common finding in an autopsy cohort of pathologically confirmed AD and associated with advancing age. This could have implications for future efforts to identify effective therapeutic strategies in dementia- favouring approaches that can target multiple age-related pathologies simultaneously.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.006 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".