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Mixed pathology is more likely in black than white decedents with Alzheimer dementia
Barnes LL, Leurgans S, Aggarwal NT, Shah RC, Arvanitakis Z, James BD, Buchman AS, Bennett DA et al.. Neurology, 2015-07-15
Topic: Amyloid, tau and blood-test diagnosis
Objective To compare the burden of neuropathology in black and white participants with clinical Alzheimer disease (AD). Methods Participants included 122 persons enrolled in the Rush Alzheimer's Disease Clinical Core, a prospective cohort study of AD. Forty-one black decedents were matched two-to-one to 81 white decedents according to age at death, sex, years of education, and cognition proximate to death. We examined common brain pathologies related to dementia (AD, Lewy body, and macroscopic and microinfarct pathology) and arteriolar sclerosis and atherosclerosis. We calculated the frequency of each dementia pathology both alone and in combination (mixed pathologies). Racial differences in the odds of a single pathology vs mixed pathologies, and in the odds of vessel disease and its severity, were examined using logistic regression analyses. Results AD pathology was confirmed in >93% of both black and white decedents with AD dementia. However, black decedents were less likely to have Alzheimer pathology as a single dementia pathology than white decedents (19.5% vs 42.0%), and were more likely to have AD mixed with an additional pathology (70.7% vs 50.6%), particularly Alzheimer pathology and Lewy bodies, and Alzheimer pathology, Lewy bodies, and infarcts. Black decedents also had more severe arteriolar sclerosis and atherosclerosis. Conclusion Black decedents with AD dementia are more likely to have mixed brain pathologies compared with age-, sex-, education-, and cognition-matched white decedents with AD dementia.
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APA 7th
Barnes, L. L., Leurgans, S., Aggarwal, N. T., Shah, R. C., Arvanitakis, Z., James, B. D., et al. (2015). Mixed pathology is more likely in black than white decedents with Alzheimer dementia. Neurology. https://doi.org/10.1212/wnl.0000000000001834
Vancouver
Barnes LL, Leurgans S, Aggarwal NT, Shah RC, Arvanitakis Z, James BD, et al. Mixed pathology is more likely in black than white decedents with Alzheimer dementia. Neurology. 2015. doi:10.1212/wnl.0000000000001834. PMID: 26180136.
BibTeX
@article{barnes2015-26180136,
author = {Barnes, L. L. and Leurgans, S. and Aggarwal, N. T. and Shah, R. C. and Arvanitakis, Z. and James, B. D. and Buchman, A. S. and Bennett, D. A. and others},
title = {{Mixed pathology is more likely in black than white decedents with Alzheimer dementia}},
journal = {Neurology},
year = {2015},
doi = {10.1212/wnl.0000000000001834},
pmid = {26180136},
url = {https://doi.org/10.1212/wnl.0000000000001834}
}
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Key findings
- Results AD pathology was confirmed in >93% of both black and white decedents with AD dementia.
- Conclusion Black decedents with AD dementia are more likely to have mixed brain pathologies compared with age-, sex-, education-, and cognition-matched white decedents with AD dementia.
Why it matters
In 122 people with Alzheimer dementia examined after death, Alzheimer brain changes were confirmed in more than 93% of both black and white decedents, but black decedents were less likely to have Alzheimer changes alone (19.5% vs 42.0%) and more likely to have them mixed with other pathology (70.7% vs 50.6%), particularly Lewy bodies and infarcts. Black decedents (n = 41) were matched to white decedents (n = 81) on age at death, sex, education and cognition near death, and also had more severe small- and large-vessel disease. This is an association in a small autopsy group; the study does not say why the difference exists.
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Study details
- Study designcohort study
- Participants122
- Effect size19.5%; 42.0%; 70.7%
- Evidence strengthModerate
How this study scored 65/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2015 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 122 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| 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 | 5 / 7 | Cited 236 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 18.2 citations a year over 13 year(s) since 2015 |
| Impact for its field and year | 3 / 6 | Cited 8.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 38 other studies in this library |
| Still being cited | 3 / 4 | Cited 81 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Julie A. Schneider: h-index 151 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Rush University Medical Center: institution h-index 670 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 26180136) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 65 / 100 | — |
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