Cause of Death Determined by Full-body Autopsy in Neuropathologically Diagnosed Dementias

Abstract

Objective: This study aimed to compare causes of death in the most prevalent neuropathologically diagnosed dementias. Methods:We analyzed causes of death in a community-based cohort of participants aged 50 or older, submitted to full-body autopsy and a comprehensive neuropathologic examination of the brain. Individuals with Alzheimer disease (AD), vascular dementia (VaD), mixed dementia (AD+VaD), or dementia with Lewy bodies (DLBs) were compared with individuals with no dementia.Results: In a sample of 920 individuals, 456 had no dementia, 147 had AD, 120 had VaD, 53 had DLB, and 37 had AD+VaD. Pneumonia as the cause of death was more frequent in the AD (P = 0.023), AD+VaD (P = 0.046), and DLB (P = 0.043) groups. In addition, VaD (P = 0.041) and AD+VaD (P = 0.028) groups had a higher frequency of atherosclerosis as detected by full-body autopsy. Conclusion:Our findings highlight the importance of preventive measures regarding atherosclerosis and pneumonia in patients with dementia. Moreover, because of cognitive impairment, these patients may not fully account for symptoms to make early detection and diagnosis possible. These results confirm findings from previous studies that were based on clinical data, with added accuracy provided by neuropathologic diagnosis and full-body autopsy reports.