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51/100

✓ Peer-reviewed alzhub usefulness score 51 out of 100. Getting a diagnosis

Topic: Amyloid, tau and blood-test diagnosis

The histopathologic changes distinguishing early Alzheimer disease (AD) from normal or pathologic aging are not clearly defined. This report describes the autopsy findings of 59 elderly, well-educated, volunteers. They were examined longitudinally with mental status testing, some for up to 8 years, as part of our normal aging study. This study reveals that (1) the brains of many subjects who did not show cognitive impairment on neuropsychologic testing contain abundant senile plaques (SP) and/or neurofibrillary tangles (NFT); (2) 29 subjects met Khachaturian criteria for AD, 15 met CERAD and 7 met National Institute on Aging-Reagan Institute guidelines; (3) Braak and Braak staging method included 9 in stage IV subjects, 4 in stage V, and 1 in stage VI; (4) there was a progression of NFT from entorhinal cortex to hippocampus and amygdala as a function of age; (5) 2 subjects met criteria for a diagnosis of dementia with Lewy bodies but were not demented; (6) cerebral amyloid angiopathy was present in leptomeningeal vessels in 75% of subjects and in parenchymal vessels in 62% of subjects; (7) only 10 of 59 subjects (17%) had no or few degenerative brain changes. Our study demonstrates that the brains of a large percentage of cognitively normal, relatively well-educated individuals contain numerous degenerative changes and only a small percentage are relatively free of these changes.

Key findings

The histopathologic changes distinguishing early Alzheimer disease (AD) from normal or pathologic aging are not clearly defined.
This report describes the autopsy findings of 59 elderly, well-educated, volunteers.
They were examined longitudinally with mental status testing, some for up to 8 years, as part of our normal aging study.
This study reveals that (1) the brains of many subjects who did not show cognitive impairment on neuropsychologic testing contain abundant senile plaques (SP) and/or neurofibrillary tangles (NFT); (2) 29 subjects met Khachaturian criteria for AD, 15 met CERAD and 7 met National Institute on Aging-Reagan Institute guidelines; (3) Braak and Braak staging method included 9 in stage IV subjects, 4 in stage V, and 1 in stage VI; (4) there was a progression of NFT from entorhinal cortex to hippocampus and amygdala as a function of age; (5) 2 subjects met criteria for a diagnosis of dementia with Lewy bodies but were not demented; (6) cerebral amyloid angiopathy was present in leptomeningeal vessels in 75% of subjects and in parenchymal vessels in 62% of subjects; (7) only 10 of 59 subjects (17%) had no or few degenerative brain changes.
Our study demonstrates that the brains of a large percentage of cognitively normal, relatively well-educated individuals contain numerous degenerative changes and only a small percentage are relatively free of these changes.

Why it matters

Autopsies of 59 elderly, well-educated volunteers who showed no cognitive impairment on testing found that many had abundant senile plaques and/or neurofibrillary tangles, and only 17% had no or few degenerative brain changes. This shows that Alzheimer-type brain changes can be present in people who are not cognitively impaired, which complicates distinguishing early Alzheimer's disease from normal aging.

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Study details

Participants29
Evidence strengthLow

How this study scored 51/100

Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Journal of neuropathology and experimental neurology)
Journal's citation record	2 / 4	Journal of Neuropathology & Experimental Neurology: journal h-index 239 (OpenAlex, 2026-10-29)
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	1999 — older than 20 years, still counted
Sample size	1 / 4	29 participants
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	6 / 7	Cited 519 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	17.9 citations a year over 29 year(s) since 1999
Impact for its field and year	4 / 6	Cited 14.6× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	4 / 6	Cited by 50 other studies in this library
Still being cited	1 / 4	Cited 14 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	4 / 4	Last-listed author William R. Markesbery: h-index 124 (OpenAlex, whole career)
Institution's track record	1 / 3	University of Kentucky: institution h-index 824 (OpenAlex)
Multi-centre collaboration	1 / 3	OpenAlex lists 2 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 10218633)
Free to read	0 / 2	Behind a paywall — scores zero
Total	51 / 100	—

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Cite this study APA, Vancouver, BibTeX · download .bib or .ris

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APA 7th

Davis, D. G., Schmitt, F. A., Wekstein, D. R., & Markesbery, W. R. (1999). Alzheimer neuropathologic alterations in aged cognitively normal subjects. Journal of neuropathology and experimental neurology. https://doi.org/10.1097/00005072-199904000-00008

Vancouver

Davis DG, Schmitt FA, Wekstein DR, Markesbery WR. Alzheimer neuropathologic alterations in aged cognitively normal subjects. Journal of neuropathology and experimental neurology. 1999. doi:10.1097/00005072-199904000-00008. PMID: 10218633.

BibTeX

@article{davis1999-10218633,
  author  = {Davis, D. G. and Schmitt, F. A. and Wekstein, D. R. and Markesbery, W. R.},
  title   = {{Alzheimer neuropathologic alterations in aged cognitively normal subjects}},
  journal = {Journal of neuropathology and experimental neurology},
  year    = {1999},
  doi     = {10.1097/00005072-199904000-00008},
  pmid    = {10218633},
  url     = {https://doi.org/10.1097/00005072-199904000-00008}
}

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