Abstract
BackgroundFunctional disability, the loss of ability to carry out daily tasks unaided, is a major adverse outcome more common with increasing age. The potential contribution of neuropathological changes in subcortical areas of the brain associated with normal ageing may be a contributing factor to this loss of function. This study investigates the clinicopathological relationship between functional ability during life and pathological correlates identified at post mortem in an UK population of older people (66–102 years).The aim is to examine the clinicopathological correlates of functional disability in subcortical neuronal populations of non-demented elderly individuals.Methods156 non-demented participants in the brain donation programme of the Medical Research Council Cognitive Function and Ageing Study (MRC-CFAS) were included in this study. Neuropathological examination was based on the CERAD protocol; pathologies of interest were amyloid plaques, neurofibrillary tangles, Lewy bodies, vascular disease and neuronal loss. Self-reported functional ability was scored according to a combined activities of daily living and instrumental activities of daily living scale.ResultsFunctional disability was equally common in men and women over 65 years, and in both sexes disability was more common at older ages. Neuronal loss in several subcortical regions elevated the risk of functional disability by three-fold (95% CI 1.3–6.6). There was evidence for a relationship between Lewy bodies in the SN and functional disability.ConclusionNeuronal loss in subcortical regions is associated with functional disability in the older population. The causal relationships are not defined and require further investigation.
Highlights
Functional disability, the loss of ability to carry out daily tasks unaided, is a major adverse outcome more common with increasing age
Functional disability was common in men and women over 65 years, and in both sexes disability was more common at older ages
Neuronal loss in several subcortical regions elevated the risk of functional disability by three-fold
Summary
Functional disability, the loss of ability to carry out daily tasks unaided, is a major adverse outcome more common with increasing age. This study investigates the clinicopathological relationship between functional ability during life and pathological correlates identified at post mortem in an UK population of older people (66–102 years). Functional disability may be defined as 'the loss of ability to carry out daily tasks unaided'[1]. The effects of disease and ageing on an individual's functional ability, and in particular their performance of activities of daily living, is one of the most common problems that has an impact on the health and quality of life in older people. We have analysed data from a large prospective, population-based cohort to investigate potential relationships between functional disability and cerebral degenerative disease in key subcortical regions (medulla, pons, midbrain and basal forebrain)
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