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Vascular pathologies and cognition in a population-based cohort of elderly people
Fernando MS, Ince PG, MRC Cognitive Function and Ageing Neuropathology Study Group.. Journal of the neurological sciences, 2004-11-01
Topic: Risk, prevention and care in population studies
The MRC Cognitive Function and Ageing Study (CFAS) is a prospective longitudinal study of a population-based cohort of elderly people in six UK sites, evaluated using psychometric instruments and questionnaires to elucidate physical and mental health. Data from the core study includes prevalence and incidence rates for dementia and longitudinal measures of cognitive decline together with data on genetic risk factors for dementia. A neuropathology study runs in collaboration with the core study based on premortem counselling of individual respondents or carers. Analysis of pathological data from the first 209 accumulated brain donations showed that both Alzheimer-type pathologies (ATP) and vascular pathologies (including congophilic amyloid angiopathy (CAA)) were common in both demented and non-demented respondents. Although many cases fulfil conventional diagnostic criteria for the pathological diagnosis of Alzheimer disease, the data differ from those published from conventional studies of hospital or memory clinic cohorts. In particular, there are individuals whose total burden of pathology is inappropriately high or low compared with their clinical dementia status, even when all pathologies are considered in a multivariable model of dementia risk factors (25% of respondents misdiagnosed from pathology findings). Vascular pathology is so common that few dementia cases lack a mixed component of both ATP and vascular lesions (pure AD cases, 21%). More recently, the study has examined white matter pathology in this cohort as a potential manifestation of small-vessel disease (SVD) in the ageing brain. Using an MRI strategy to image formalin-fixed brain slices, the study shows that white matter lesions (WMLs) are common (94% overall frequency) and are an independent risk factor for dementia using multivariable analysis.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Fernando, M. S., Ince, P. G., & MRC Cognitive Function and Ageing Neuropathology Study Group. (2004). Vascular pathologies and cognition in a population-based cohort of elderly people. Journal of the neurological sciences. https://doi.org/10.1016/j.jns.2004.09.004
Vancouver
Fernando MS, Ince PG, MRC Cognitive Function and Ageing Neuropathology Study Group. Vascular pathologies and cognition in a population-based cohort of elderly people. Journal of the neurological sciences. 2004. doi:10.1016/j.jns.2004.09.004. PMID: 15537512.
BibTeX
@article{fernando2004-15537512,
author = {Fernando, M. S. and Ince, P. G. and {MRC Cognitive Function and Ageing Neuropathology Study Group}},
title = {{Vascular pathologies and cognition in a population-based cohort of elderly people}},
journal = {Journal of the neurological sciences},
year = {2004},
doi = {10.1016/j.jns.2004.09.004},
pmid = {15537512},
url = {https://doi.org/10.1016/j.jns.2004.09.004}
}
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Key findings
- Analysis of pathological data from the first 209 accumulated brain donations showed that both Alzheimer-type pathologies (ATP) and vascular pathologies (including congophilic amyloid angiopathy (CAA)) were common in both demented and non-demented respondents.
- In particular, there are individuals whose total burden of pathology is inappropriately high or low compared with their clinical dementia status, even when all pathologies are considered in a multivariable model of dementia risk factors (25% of respondents misdiagnosed from pathology findings).
- Using an MRI strategy to image formalin-fixed brain slices, the study shows that white matter lesions (WMLs) are common (94% overall frequency) and are an independent risk factor for dementia using multivariable analysis.
Why it matters
In this population-based brain donation study, both Alzheimer-type and vascular pathologies were common in people with and without dementia, and about 25% of respondents were misdiagnosed from pathology findings. This highlights how mixed and complex dementia pathology is, but it does not test a treatment, cure, or prevention.
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Study details
- Study designlongitudinal study
- Evidence strengthModerate
How this study scored 53/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the neurological sciences) |
| Journal's citation record | 2 / 4 | Journal of the Neurological Sciences: journal h-index 233 (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 | 1 / 5 | 2004 — 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) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 240 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 10.0 citations a year over 24 year(s) since 2004 |
| Impact for its field and year | 3 / 6 | Cited 7.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 25 other studies in this library |
| Still being cited | 1 / 4 | Cited 13 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Paul G. Ince: h-index 102 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Sheffield: institution h-index 1,017 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 15537512) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 53 / 100 | — |
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