NEUROPATHOLOGY OF OLDER PERSONS WITHOUT COGNITIVE IMPAIRMENT
FROM TWO COMMUNITY-BASED STUDIES
David A. Bennett MD, Julie A. Schneider MD, Zoe Arvanitakis MD, Jeremiah F. Kelly MD, Neelum T.
Aggarwal MD, Raj C. Shah MD, Robert S. Wilson PhD.
Rush Alzheimer's Disease Center (DAB, JAS, ZA, JFK, NTA, RCS, RSW); Department of Neurological
Sciences (DAB, JAS, ZA, NTA, RSW); Department of Pathology (Neuropathology, JAS); Department
of Internal Medicine (JFK); Department of Family Practice (RCS); Department of Behavioral Sciences
(RSW); Rush University Medical Center, Chicago, IL.
Address correspondence to: David A. Bennett, MD; Rush Alzheimer’s Disease Center; 600 South
Paulina, Suite 1028; Chicago, IL. 60612. 312-942-2362, email@example.com
Bennett et al. 2
Abstract -- Objectives: Examine the relation of National Institute on Aging-Reagan (NIA-Reagan)
neuropathologic criteria of AD to level of cognitive function in persons without dementia or MCI.
Methods: More than 2,000 persons without dementia participating in the Religious Orders Study or the
Memory and Aging Project agreed to annual detailed clinical evaluation and brain donation. The studies
had 19 neuropsychological performance tests in common that assessed five cognitive domains, including
episodic memory, semantic memory, working memory, perceptual speed and visuospatial ability. 134
persons without cognitive impairment died and underwent brain autopsy and post-mortem assessment
for AD pathology using NIA-Reagan neuropathologic criteria for AD, cerebral infarctions, and Lewy
bodies. Linear regression was used to examine the relation of AD pathology to level of cognitive
function proximate to death. Results: Two (1.5%) persons met NIA-Reagan criteria for high likelihood
AD, and 48 (35.8%) met criteria for intermediate likelihood; 29 (21.6%) had cerebral infarctions, and 18
(13.4%) had Lewy bodies. The mean Mini-Mental Status Examination score proximate to death was
28.2 for those meeting high or interme