The revised national Alzheimer's coordinating center's neuropathology form-available data and new analyses

Lilah M. Besser, Walter A. Kukull, Merilee A. Teylan, Eileen H. Bigio, Nigel J. Cairns, Julia K. Kofler, Thomas J. Montine, Julie A. Schneider, Peter T. Nelson

Research output: Contribution to journalArticlepeer-review

65 Scopus citations


Neuropathologic evaluation remains the gold standard for determining the presence and severity of aging-related neurodegenerative diseases. Researchers at U.S. Alzheimer's Disease Centers (ADCs) have worked for >30 years studying human brains, with the goals of achieving new research breakthroughs. Harmonization and sharing among the 39 current and past ADCs is promoted by the National Alzheimer's Coordinating Center (NACC), which collects, audits, and disburses ADC-derived data to investigators on request. The past decades have witnessed revised disease definitions paired with dramatic expansion in the granularity and multimodality of the collected data. The NACC database now includes cognitive test scores, comorbidities, drug history, neuroimaging, and links to genomics. Relatively, recent advances in the neuropathologic diagnoses of Alzheimer's disease, frontotemporal lobar degeneration (FTLD), and vascular contributions to cognitive impairment and dementia catalyzed a 2014 update to the NACC Neuropathology Form completed by all ADCs. New focal points include cerebrovascular disease (including arteriolosclerosis, microbleeds, and microinfarcts), hippocampal sclerosis, TDP-43, and FTLD. Here, we provide summary data and analyses to illustrate the potential for both hypothesis-testing and also generating new hypotheses using the NACC Neuropathology data set, which represents one of the largest multi-center databases of carefully curated neuropathologic information that is freely available to researchers worldwide.

Original languageEnglish
Pages (from-to)717-726
Number of pages10
JournalJournal of Neuropathology and Experimental Neurology
Issue number8
StatePublished - Aug 1 2018

Bibliographical note

Funding Information:
From the Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, Washington (LMB, WAK, MAT); Institute for Healthy Aging and Lifespan Studies and School of Urban and Regional Planning, Florida Atlantic University, Boca Raton, Florida (LMB); Feinberg School of Medicine, Northwestern University, Chicago, Illinois (EHB); Department of Neurology, Washington Univer-sity in St Louis, St. Louis, Missouri (NJC); Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania (JKK); Department of Pathology, Stanford University, Stanford, California (TJM); Department of Pathology, Rush University, Chicago, Illinois (JAS); and Sanders-Brown Center on Aging, Division of Neuropathology, Department of Pathology, University of Kentucky, Lexington, Kentucky (PTN) Send correspondence to: Lilah M. Besser, PhD, School of Urban and Regional Planning, Florida Atlantic University, 777 Glades Rd, SO-44 Room 371, Boca Raton, FL 33431; E-mail: The NACC database is funded by NIA/NIH Grant U01 AG016976. The study was supported by NIH grants P01 AG003991, P30 AG028383, P30 AG013854, AG047366, P50 AG005133, P50 AG005681.

Publisher Copyright:
© 2018 American Association of Neuropathologists, Inc. All rights reserved.


  • Lewy
  • MRI
  • Primary age-related tauopathy (PART)
  • Stroke
  • Subjective memory complaint (SMC)
  • Tauopathy

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Neurology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience


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