592Patients with dementia from multiple pathology often have a combination of Alzheimer's disease (AD) co-existing with Vascular Dementia (VaD) and/or Dementia with Lewy Bodies (DLB). Mixed AD, that is, AD co-existing with other pathology, is increasingly being recognized in clinical practice with an estimated prevalence of over 50% in community-dwelling dementia patients.1-3 AD typically involves marked anterograde amnesia, whereas VaD is often characterized by focal neurological symptoms, abrupt or stepwise progression, executive dysfunction and psychomotor slowing.4 By contrast, DLB is commonly associated with fluctuating cognition with variable attention and alertness, visual perceptual disturbances or hallucinations, and early extrapyramidal symptoms, as well as rapid eye movement (REM) sleep disturbances and neuroleptics sensitivity.5 There are no universally accepted diagnostic criteria Results: Autopsy reports were available for 16/47 (34%) of deceased patients. of these 16 patients, 5 (31%) had pure AD pathology, 10 (63%) had AD with other pathology, and 1 (6%) had non-AD pathology. Compared to patients with pure AD, patients with AD mixed with other pathology had poorer baseline FRs in problem-solving (p<0.01) and community affairs (p<0.02). Conclusion: While the strict enrollment criteria for clinical trials identified the presence of AD pathology in the majority of cases (15/16), multiple pathology was more common than pure AD in our series of autopsied patients. Premortem biomarkers that can distinguish between pure AD and AD with multiple pathology will be beneficial in future clinical trials and dementia patient management. . Parmi ces 16 patients, 5 (31%) avaient une MA pure au point de vue anatomopathologique, 10 (63%) avaient une MA associée à une autre pathologie et 1 (6%) avait une pathologie autre que la MA. Par rapport aux patients atteints d'une MA pure, les patients atteints de la MA associée à une autre pathologie avaient un score à l'ÉEF initiale plus faible pour la résolution de problèmes (p < 0,01) et la participation à la vie communautaire (p < 0,02). Conclusion : Bien que les critères de sélection stricts dans les études cliniques identifiaient la présence de la pathologie de la MA chez la majorité des patients (15/16), la présence de pathologies multiples était plus fréquente que la MA pure à l'autopsie dans cette série de patients. Des biomarqueurs qui peuvent distinguer la MA pure de la MA associée à des pathologies multiples du vivant du patient seront fort utiles pour les études cliniques à venir ainsi que pour le traitement des patients.
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