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Person-specific contribution of neuropathologies to cognitive loss in old age
Boyle PA, Yu L, Wilson RS, Leurgans SE, Schneider JA, Bennett DA.. Annals of neurology, 2018-01-14
Topic: Risk, prevention and care in population studies
Objective Mixed neuropathologies are the most common cause of dementia at the population level, but how different neuropathologies contribute to cognitive decline at the individual level remains unknown. We quantified the contribution of 9 neuropathologies to cognitive loss at an individual level. Methods Participants (n = 1,079) came from 2 longitudinal clinical-pathologic studies of aging. All completed 2 + cognitive evaluations (maximum = 22), died, and underwent neuropathologic examinations to identify Alzheimer disease (AD), other neurodegenerative diseases, and vascular pathologies. Linear mixed models examined associations of neuropathologies with cognitive decline and estimated the proportion of cognitive loss accounted for by each neuropathology at a person-specific level. Results Neuropathology was ubiquitous, with 94% of participants having 1+, 78% having 2+, 58% having 3+, and 35% having 4+. AD was most frequent (65%) but rarely occurred in isolation (9%). Remarkably, >230 different neuropathologic combinations were observed, each of which occurred in Interpretation There is much greater heterogeneity in the comorbidity and cognitive impact of age-related neuropathologies than currently appreciated, suggesting an urgent need for novel therapeutic approaches that embrace the complexity of disease to combat cognitive decline in old age. Ann Neurol 2018;83:74-83.
Key findings
- Results Neuropathology was ubiquitous, with 94% of participants having 1+, 78% having 2+, 58% having 3+, and 35% having 4+.
Why it matters
This study followed 1,079 older people from two long-running aging studies with repeated memory and thinking tests (2 to 22 each), then examined their brains after death. Brain disease was nearly universal: 94% had at least one pathology, 78% had two or more and 35% had four or more. Alzheimer's disease was the most common (65%) but appeared alone in only 9%, and more than 230 different combinations were seen. The study set out to estimate how much each pathology contributed to each person's cognitive decline, but those results are not included in this record. It is an observational study and tests no treatment.
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Study details
- Study designlongitudinal study
- Participants1,079
- Evidence strengthModerate
How this study scored 70/100
Published in a leading specialty journal, and it is a longitudinal study following the same people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of neurology) |
| Journal's citation record | 3 / 4 | Annals of Neurology: journal h-index 437 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same 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 | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,079 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 509 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 50.9 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 5 / 6 | Cited 29.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 44 other studies in this library |
| Still being cited | 3 / 4 | Cited 163 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author David Alan Bennett: h-index 197 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Rush University Medical Center: institution h-index 670 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 29244218) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 70 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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.
APA 7th
Boyle, P. A., Yu, L., Wilson, R. S., Leurgans, S. E., Schneider, J. A., & Bennett, D. A. (2018). Person-specific contribution of neuropathologies to cognitive loss in old age. Annals of neurology. https://doi.org/10.1002/ana.25123
Vancouver
Boyle PA, Yu L, Wilson RS, Leurgans SE, Schneider JA, Bennett DA. Person-specific contribution of neuropathologies to cognitive loss in old age. Annals of neurology. 2018. doi:10.1002/ana.25123. PMID: 29244218.
BibTeX
@article{boyle2018-29244218,
author = {Boyle, P. A. and Yu, L. and Wilson, R. S. and Leurgans, S. E. and Schneider, J. A. and Bennett, D. A.},
title = {{Person-specific contribution of neuropathologies to cognitive loss in old age}},
journal = {Annals of neurology},
year = {2018},
doi = {10.1002/ana.25123},
pmid = {29244218},
url = {https://doi.org/10.1002/ana.25123}
}
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