Prevalence of mixed neuropathologies in age-related neurodegenerative diseases: A community-based autopsy study in China.
Level 4 - case-series / case-control
Multi-center post-mortem cross-sectional / autopsy case series
PubMed 39582417 · doi:10.1002/alz.14369
What was done
Pathologists examined 1,142 post-mortem human brains collected across six brain banks in China using standardized neuropathological protocols and independent quality-controlled evaluations. The study assessed the prevalence, co-occurrence, and regional variations of common age-related neurodegenerative and vascular brain pathologies.
What was found
Pathological evaluations identified high rates of mixed brain pathologies across the cohort: - Cerebrovascular disease (CVD): 63% - Alzheimer's disease neuropathological change (ADNC): 48% - Limbic-predominant age-related TDP-43 encephalopathy (LATE): 46% - Primary age-related tauopathy (PART): 35% - Lewy body disease (LBD): 13% - Aging-related tau astrogliopathy (ARTAG): 12% Pathologies frequently co-occurred and varied by geographic region. Pathological patterns indicated that CVD was the earliest developing pathology, potentially preceding other neurodegenerative changes.
Why it matters
This study provides large-scale neuropathological prevalence data from China, demonstrating that mixed brain pathologies—particularly the combination of vascular lesions, ADNC, and LATE—are widespread and comparable in frequency to findings reported in Western autopsy cohorts.
Limits
Brain donor cohorts carry inherent donation and survival biases and do not fully reflect the general living population. The abstract does not provide demographic breakdowns (e.g., age, sex), ante-mortem cognitive or clinical data, or quantitative metrics for the regional differences. The post-sectional autopsy design infers rather than directly observes the temporal sequence of disease progression.
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- contradicts Postmortem brain tissue from Alzheimer's disease patients consistently displays vascular pathology across every single case.