A population study on blood-brain barrier function in 85-year-olds: relation to Alzheimer's disease and vascular dementia

• Published in: Neurology Vol. 50; no. 4; p. 966
• Main Authors: Skoog, I, Wallin, A, Fredman, P, Hesse, C, Aevarsson, O, Karlsson, I, Gottfries, C G, Blennow, K
• Format: Journal Article
• Language: English
• Published: United States 01.04.1998
• Subjects: Aged; Aged, 80 and over; Aging - physiology; Albumins - cerebrospinal fluid; Alzheimer Disease - blood; Alzheimer Disease - cerebrospinal fluid; Alzheimer Disease - physiopathology; Apolipoprotein E3; Apolipoproteins E - genetics; Blood-Brain Barrier - physiology; Cardiovascular Physiological Phenomena; Dementia, Vascular - blood; Dementia, Vascular - cerebrospinal fluid; Dementia, Vascular - physiopathology; Female; Genotype; Humans; Longitudinal Studies; Male; Serum Albumin - metabolism
• ISSN: 0028-3878
• DOI: 10.1212/WNL.50.4.966

We investigated blood-brain barrier (BBB) function in relation to Alzheimer's disease (AD) and vascular dementia (VAD) in the very elderly. Sixty-five 85-year-old persons from a population-based sample were followed for 3 years; 29 were demented at age 85 (13 with AD, 14 with VAD, and 2 with other dementias), 7 developed dementia during follow-up, and 29 remained nondemented. CSF/serum albumin ratio was used as as a measure of BBB function. Dementia was defined according to the DSM-III-R, AD according to the NINCDS-ADRDA criteria, and VAD according to the NINDS-Association Internationale pour la Recherche et l'Enseignement en Neurosciences (AIREN) criteria. Mean CSF/serum albumin ratio was higher in all dementias (8.5 +/- 4.3; p = 0.007) and in the subtypes AD (8.9 +/- 5.3; p = 0.046) and VAD (8.7 +/- 3.5; p = 0.002) than in nondemented individuals (versus 6.5 +/- 2.0), but it was not related to dementia severity. Nondemented women at age 85 (n = 3) who developed dementia during the follow-up had a higher CSF/serum albumin ratio than those not developing dementia (10.4 +/- 2.0 versus 6.0 +/- 1.9; p = 0.007). Nondemented individuals lacking the apolipoprotein E epsilon3 allele (n = 4) had a higher CSF/serum albumin ratio (9.3 +/- 0.8 versus 6.6 +/- 2.1; p = 0.029) than other individuals. A relative BBB dysfunction is associated with both AD and VAD among very elderly individuals. This finding is possibly found early in the disease before the onset of clinical dementia.