Objective: The traditionally held notion that widespread neuronal death in the neocortex and hippocampus is an inevitable concomitant of normal brain aging has been recently questioned by stereological studies suggesting that neuronal death is very restricted topographically in normal aging, and unlikely to account for age-related impairment in neocortical and hippocampal functions. The present study aims to clairify the relationship between stereological estimates of Alzheimer's disease-related neuronal loss and severity of cognitive deficits in brain aging.
Design: Clinicopathologic study in 22 elderly cases.
Materials and Methods: Cognitive status assessed prospectively using the Mini Mental Score Examination (MMSE); stereologic assessment of unaffected neurons in the CA1 field of the hippocampus, entorhinal cortex, and area 9. Statistical analysis was performed using both univariate and multivariate linear regression models.
Results: A very high proportion of the variability in MMSE scores was explained by neuronal counts in the CA1 field (85.4%), entorhinal cortex (83.7%) and area 9 (79%); Multivariate analyses showed that neuron numbers in the CA1 field was the best predictor of MMSE score.
Conclusion: These new stereological data indicate that neuronal loss in hippocampal formation closely reflects the progression of cognitive deficits in brain aging and Alzheimer’s disease.
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