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Hippocampal Atrophy Common in “Oldest Old”

JAMA Neurol; ePub 2017 Nov 6; Zhao, et al

In the oldest old without dementia, presence of either or both amyloid β (Aβ) and hippocampal atrophy is typical (>75%), according to a recent study. These findings suggest different underlying pathophysiologic processes in the Aβ+/neurodegeneration (ND)− and Aβ−/ND+ groups. A longitudinal observational study was conducted from August 24, 2000, to January 14, 2016, including and extending observations from the Ginkgo Evaluation of Memory study. A total of 197 adults who had completed the memory study, were free of dementia, and were able to undergo magnetic resonance imaging, were eligible for a neuroimaging study. Of these patients, 175 were included in the present analyses; 140 (80%) were cognitively normal and 35 (20%) had mild cognitive impairment; mean (SD) age was 86.0 (2.9) years. Researchers found:

  • A total of 42 participants (24.0%) were Aβ−/ND−, 32 (18.3%) were Aβ+/ND−, 35 (20.0%) were Aβ−/ND+, and 66 (37.7%) were Aβ+/ND+.
  • On all cognitive measures, the Aβ+/ND+ group showed the steepest decline.


Zhao Y, Tudorascu DL, Lopez OL, et al. Amyloid β deposition and suspected non-Alzheimer pathophysiology and cognitive decline patterns for 12 years in oldest old participants without dementia. [Published online ahead of print November 6, 2017]. JAMA Neurol. doi:10.1001/jamaneurol.2017.3029.

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