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 Association between male gender and LB pathology 
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Joined: Fri Aug 11, 2006 1:46 pm
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Post Association between male gender and LB pathology
This is more published research coming out of the large National Alzheimer's Coordinating Center (NACC) Registry autopsy series, where the research is coordinated by the University of Kentucky. A major paper from this group last year showed the diagnostic accuracy of "pure" DLB was 32% and mixed DLB/AD was 12%!

This paper compares the association between gender and cortical Lewy body pathology in this large autopsy series. "Cases with Alzheimer's disease (AD), neocortical LBs, AD + neocortical LBs, or neither pathology were evaluated as separate groups."

The findings were not surprising. "Patients with neocortical ('diffuse') or intermediate ('limbic') LB pathologies tended to be male. ... By contrast, individuals dying with AD pathology were more likely to be female if dying over 80, but that tendency was not seen in individuals dying with AD pathology prior to age 80."

"Increased understanding of the male predominance in neocortical LB pathology may help guide clinicians..."

Robin



Journal of Neurology. 2010 Jun 20. [Epub ahead of print]

Association between male gender and cortical Lewy body pathology in large autopsy series.

Nelson PT, Schmitt FA, Jicha GA, Kryscio RJ, Abner EL, Smith CD, Van Eldik LJ, Markesbery WR.
Division of Neuropathology, Department of Pathology, Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY.

Abstract
Sex-linked factors may alter risk for neurodegenerative diseases. Definitive diagnoses are not established until autopsy, so neuropathological studies are critical. There have not been reported gender-related differences in neocortical Lewy bodies (LBs) using large multi-center autopsy series. We evaluated the associations between gender and pathologically characterized neurodegenerative diseases.

Cases with Alzheimer's disease (AD), neocortical LBs, AD + neocortical LBs, or neither pathology were evaluated as separate groups.

Results were corrected for possible confounders including age at death, smoking history, and education.

The settings were the University of Kentucky Alzheimer's Disease Center and the National Alzheimer's Coordinating Center (NACC) Registry autopsy series; 3,830 subjects met inclusion criteria.

Patients with neocortical ("diffuse") or intermediate ("limbic") LB pathologies tended to be male (male:female odds ratios ~2.9 with 95% CI 2.02-4.18). The preponderance of males dying with neocortical LB pathology was seen consistently across age groups and was not due to the potential confounders evaluated.

By contrast, individuals dying with AD pathology were more likely to be female if dying over 80 (male:female odds ratio 0.66, 95% CI 0.50-0.88), but that tendency was not seen in individuals dying with AD pathology prior to age 80.

Increased understanding of the male predominance in neocortical LB pathology may help guide clinicians, because males are more likely to be "undercalled" for neocortical LBs clinically, and females are more likely to be "overcalled" (P < 0.05 for both). Males are far more likely than females to die with neocortical LB pathology. This phenomenon may help guide medical practice including clinical trial study design.

PubMed ID#: 20563821 (see pubmed.gov for this abstract only)


Sat Jun 26, 2010 12:41 am
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