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Association of lewy bodies, hippocampal sclerosis and amyloid angiopathy with dementia in community-dwelling elderly: A systematic review and meta-analysis

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INTRODUCTION We measured the proportion of Lewy body pathology (LB), hippocampal sclerosis (HS), and cerebral amyloid angiopathy (CAA) among community-dwelling people with and without dementia. METHODS We searched for community-based… Click to show full abstract

INTRODUCTION We measured the proportion of Lewy body pathology (LB), hippocampal sclerosis (HS), and cerebral amyloid angiopathy (CAA) among community-dwelling people with and without dementia. METHODS We searched for community-based cohorts with postmortem brain autopsy until 1 January 2020. We calculated the summary risk difference and 95% confidence interval (95% CI) using a random-effects model in R. RESULTS We found 12 articles, comprising 2197 demented and 2104 non-demented participants. LB, HS, CAA were prevalent lesions among community-dwelling elderly (15%, 10%, and 24%, respectively). These significantly increased the risk of dementia (LB: risk difference 38%, 95% CI 20-56%, HS: 34%, 24-44%, CAA: 19%, 3-34%). 20% of cases with neocortical LB, 17% with bilateral HS, and 42% with moderate/severe CAA pathology remained non-demented by death. DISCUSSION LB or HS or CAA are common neuropathologies among community-dwelling elderly. Although these lesions independently are associated with dementia, many remain non-demented, by death.

Keywords: hippocampal sclerosis; dementia; community; pathology; community dwelling; dwelling elderly

Journal Title: Journal of Clinical Neuroscience
Year Published: 2021

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