Risk factors of hippocampal sclerosis in the oldest old: The 90+ Study

Thomas Trieu, Seyed Ahmad Sajjadi, Claudia H. Kawas, Peter T. Nelson, María M. Corrada

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Objective To examine the risk factors and comorbidities of hippocampal sclerosis (HS) in the oldest-old. Methods A total of 134 participants with dementia from The 90+ Study with longitudinal evaluations and autopsy were included in this investigation. Participants were divided into 2 groups, one with and one without HS pathology, and differences in clinical and pathologic characteristics were compared. Results Persons with HS tended to have a longer duration of dementia compared to participants without HS (mean 4.0 years vs 6.7 years, odds ratio [OR] 1.26; 95% confidence interval [CI] 1.11-1.42; p < 0.001). HS was more likely in participants with a history of autoimmune diseases (rheumatoid arthritis or thyroid disease, OR 3.15; 95% CI 1.30-7.62; p = 0.011), high thyroidstimulating hormone (OR 4.94; 95% CI 1.40-17.46; p = 0.013), or high thyroid antibodies (OR 3.45; 95% CI 1.09-10.88; p = 0.035). Lewy body disease (LBD) pathology was also associated with an increased likelihood of HS (OR 5.70; 95% CI 1.22-26.4; p = 0.027). Conclusion We identified autoimmune conditions (rheumatoid arthritis and thyroid disease) as potential risk factors for HS in our cohort. LBD was the only pathology that was associated with increased odds of HS and those harboring HS pathology had a longer duration of dementia. This suggests multiple pathways of HS pathology among the oldest-old.

Original languageEnglish
Pages (from-to)E1788-1798
JournalNeurology
Volume91
Issue number19
DOIs
StatePublished - Nov 6 2018

Bibliographical note

Funding Information:
This study was funded by grants from the NIH (R01AG021055 and P50AG016573) and The Medical Student Training in Aging Research (MSTAR) Program from AFAR and NIA.

Publisher Copyright:
© 2018 American Academy of Neurology.

ASJC Scopus subject areas

  • Clinical Neurology

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