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7 - Neuropathology of the ageing brain

Published online by Cambridge University Press:  12 October 2009

Patrick R. Hof
Affiliation:
Fishberg Research Center for Neurobiology, Kastor Neurobiology of Aging Laboratories, and Department of Geriatrics and Adult Development Mount Sinai School of Medicine, New York, USA
Thierry Bussière
Affiliation:
Elan Pharmaceuticals, South San Francisco, CA, USA
John H. Morrison
Affiliation:
Fishberg Research Center for Neurobiology, Kastor Neurobiology of Aging Laboratories, and Department of Geriatrics and Adult Development Mount Sinai School of Medicine, New York, USA
Margaret M. Esiri
Affiliation:
University of Oxford
Virginia M. -Y. Lee
Affiliation:
University of Pennsylvania School of Medicine
John Q. Trojanowski
Affiliation:
University of Pennsylvania School of Medicine
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Summary

Introduction

Due to the increasing longevity of the population across the world, a consistently high prevalence of age-related cognitive deficits has been reported in recent years. Numerous studies have shown that a variety of deficits can be observed clinically, ranging from absence of symptoms with preservation of cognitive and intellectual functions, to severe cognitive disturbances typical of dementia of the Alzheimer type. Alongside the ageing process, several morphological and pathological alterations have been described neuropathologically. The occurrence of the typical Alzheimer-like lesions, namely neurofibrillary tangles (NFT) and senile plaques (SP), is the most obvious feature revealed by microscopic examination in the brain of elderly individuals (Fig. 7.1). However, the extent and distribution of these lesions differ from the classical pathological pattern seen in Alzheimer's disease (AD). Fine morphological techniques have been used to demonstrate that neuronal and synaptic loss also occur during the normal ageing process of the brain. Moreover, changes affecting the cerebral vasculature are not classically described, although they may be an important factor contributing to the age-related deficit in brain function. Finally, subtle alterations in myelinated fibres can be detected in the brains of elderly individuals by using the most advanced in vivo imaging techniques.

NFT and SP distribution in normal ageing

NFT and SP are the two main neuropathological hallmarks required to ascertain the definitive diagnosis of AD (Mirra et al., 1993). However, several studies have shown that a substantial number of these AD-related changes are found in aged individuals with normal cognitive function, demonstrating that the pathological process must begin at an earlier stage when clinical detection is not yet possible (Table 7.1).

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Publisher: Cambridge University Press
Print publication year: 2004

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  • Neuropathology of the ageing brain
    • By Patrick R. Hof, Fishberg Research Center for Neurobiology, Kastor Neurobiology of Aging Laboratories, and Department of Geriatrics and Adult Development Mount Sinai School of Medicine, New York, USA, Thierry Bussière, Elan Pharmaceuticals, South San Francisco, CA, USA, John H. Morrison, Fishberg Research Center for Neurobiology, Kastor Neurobiology of Aging Laboratories, and Department of Geriatrics and Adult Development Mount Sinai School of Medicine, New York, USA
  • Edited by Margaret M. Esiri, University of Oxford, Virginia M. -Y. Lee, University of Pennsylvania School of Medicine, John Q. Trojanowski, University of Pennsylvania School of Medicine
  • Book: The Neuropathology of Dementia
  • Online publication: 12 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511526886.008
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  • Neuropathology of the ageing brain
    • By Patrick R. Hof, Fishberg Research Center for Neurobiology, Kastor Neurobiology of Aging Laboratories, and Department of Geriatrics and Adult Development Mount Sinai School of Medicine, New York, USA, Thierry Bussière, Elan Pharmaceuticals, South San Francisco, CA, USA, John H. Morrison, Fishberg Research Center for Neurobiology, Kastor Neurobiology of Aging Laboratories, and Department of Geriatrics and Adult Development Mount Sinai School of Medicine, New York, USA
  • Edited by Margaret M. Esiri, University of Oxford, Virginia M. -Y. Lee, University of Pennsylvania School of Medicine, John Q. Trojanowski, University of Pennsylvania School of Medicine
  • Book: The Neuropathology of Dementia
  • Online publication: 12 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511526886.008
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Neuropathology of the ageing brain
    • By Patrick R. Hof, Fishberg Research Center for Neurobiology, Kastor Neurobiology of Aging Laboratories, and Department of Geriatrics and Adult Development Mount Sinai School of Medicine, New York, USA, Thierry Bussière, Elan Pharmaceuticals, South San Francisco, CA, USA, John H. Morrison, Fishberg Research Center for Neurobiology, Kastor Neurobiology of Aging Laboratories, and Department of Geriatrics and Adult Development Mount Sinai School of Medicine, New York, USA
  • Edited by Margaret M. Esiri, University of Oxford, Virginia M. -Y. Lee, University of Pennsylvania School of Medicine, John Q. Trojanowski, University of Pennsylvania School of Medicine
  • Book: The Neuropathology of Dementia
  • Online publication: 12 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511526886.008
Available formats
×