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Brain Infarction and the Clinical Expression of Alzheimer Disease-Reply
David A. Snowdon. JAMA, 1997-07-09
Topic: Amyloid, tau and blood-test diagnosis
In Reply. —The analyses of Drs Mirra and Gearing indicate that brain infarcts are not associated with NFTs in the neocortex. Our analyses also indicated that brain infarcts were not associated with the number of NFTs, senile plaques, or neuritic plaques in the neocortex, suggesting that AD lesions and brain infarcts were likely to have occured independently of each other. While AD and brain infarction may represent separate disease processes, their combination may nonetheless increase the likelihood that dementia will occur. Among the participants in our study who met our neuropathologic criteria for AD (ie, abundant senile plaques and some NFTs in the neocortex), those with 1 or 2 lacunar infarcts in the basal ganglia, thalamus, or deep white matter had an especially high prevalence of dementia, compared with those without brain infarcts. The prevalence of dementia was 93% for those with such subcortical lacunar infarcts and 57% in those without infarcts.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Snowdon, D. A. (1997). Brain Infarction and the Clinical Expression of Alzheimer Disease-Reply. JAMA. https://doi.org/10.1001/jama.1997.03550020046024
Vancouver
Snowdon DA. Brain Infarction and the Clinical Expression of Alzheimer Disease-Reply. JAMA. 1997. doi:10.1001/jama.1997.03550020046024.
BibTeX
@article{snowdon1997-b8bd5c53,
author = {Snowdon, David A.},
title = {{Brain Infarction and the Clinical Expression of Alzheimer Disease-Reply}},
journal = {JAMA},
year = {1997},
doi = {10.1001/jama.1997.03550020046024},
url = {https://doi.org/10.1001/jama.1997.03550020046024}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Why it matters
In this reply letter, the authors report that brain infarcts were not associated with the number of tangles or plaques in the neocortex, suggesting the two occur independently. Among participants who met their criteria for Alzheimer's, dementia prevalence was 93% in those with subcortical lacunar infarcts and 57% in those without.
How this study scored 47/100
Published in a top-tier journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it. We have no data on strength of evidence and institution's track record, so those were left out: it earned 43 of the 92 points we could judge it on, which is 47 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (JAMA) |
| Journal's citation record | 4 / 4 | JAMA: journal h-index 1,011 (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 | — / 5 | No evidence rating recorded — left out of this score |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1997 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 675 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 21.8 citations a year over 31 year(s) since 1997 |
| Impact for its field and year | 4 / 6 | Cited 15.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author David A. Snowdon: h-index 51 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 43 / 92 | Scored on 18 of 20 parts. We have no data for the rest, so they are left out: 43 of the 92 points we could judge it on is 47 out of 100. |
| Total | 47 / 100 | — |
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