Studies on the morphological background of dementia in old Age-a clinicopathological investigation on the cases with abundant senile plaques
1979 Volume 16 Issue 1 Pages 1-6
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1979 Volume 16 Issue 1 Pages 1-6
It is known that the main etiology of dementia in old age in a geriatic general hospital is that of vascular type and on the other hand, dementia of Alzheimer type (senile dementia), is few. This study was performed to ellucidate the incidence of the senile dementia on the autopsied brains. Material came from 500 autopsied brains of over 60 year-old persons. Among them, 44 cases with abundant senile plaques in temporal lobes including Ammon horn (SP group) and 50 cases without senile plaques were selected and examined pathologically. Results were as folows:.
1) Incidnence of SP cases increased in higher ages and they showed dementia in 85%.
2) SP cases showed a prominent cortcal atrophy, while ventricular dilatation was much more in SP-negative cases.
3) Marked cerebral arteriosclerosis was observed in 57% of SP cases and 74% of SP-negative cases. Vascular lesions were noted in 65% of SP cases and in 75% of SP-negative cases.
4) Six SP cases without arteriosclerosis and vascular lesion were found in 2 males and 4 females of ages from 65 to 84 year-old. Decrease of the brain weight, senile plaques in cerebral cortex, especially in occipital and temporal lobes, loss of nerve cells in cortex, Alzhemier's neurofibrillay change, granulovacuolar degeneration, Hirano bodies, etc. were obsered. There were no hypertensives and their clinical diagnosis was other than the senile dementia.
5) Morphological classification on 101 cases of dementia in old age, except other etiology, revealed vascular type in 54% and senile dementia (pure form) in 16% and senile dementia with/without slight vasculr changes in 32%. It seemed, however, difficult to classify the cases with combined changes to the “mixed type” of dementia of both vascular and Alzheimer types.
