Co-Prevalence of Alzheimer's Disease and Age-Related Macular Degeneration Established by Histopathologic Diagnosis.

BACKGROUND: Previous epidemiologic studies have suggested an association between AMD and AD, and several therapeutic agents are being developed based on this principle. However, prior studies have provided conflicting results due in part to their reliance on clinical diagnoses that are not based on gold-standard histopathology. OBJECTIVE: To use histopathologic standards for diagnosis in order to determine the co-prevalence of AD among patients with and without AMD. METHODS: This is a cross-sectional study of 157 autopsy ocular specimens from patients with and without AMD that were greater than 75 years of age at death. Sarks staging was used to document the severity of AMD, and Braak and Braak staging was used to assess the severity of AD in corresponding brain specimens. The prevalence of AD within different severities of AMD was determined using univariable and multivariable logistic regression. RESULTS: 58% of autopsy eyes had AMD. The prevalence of AD was lower in AMD subjects (63%) compared to non-AMD subjects (73%), even when grouped by severity (all p > 0.15). The likelihood of AD was significantly less in AMD subjects, even after adjusting for age and sex in multivariable analysis (OR 0.47, p = 0.049). CONCLUSION: Histopathologic diagnoses fail to support an increase in prevalence of AD among subjects with AMD, even when disease severity is considered.

Duke Scholars

Author Eleonora Georgeta Lad Ophthalmology, Vitreoretinal Diseases & Surgery

Author Sandra Sue Stinnett Biostatistics & Bioinformatics, Division of Biostatistics

Author Heather Elizabeth Whitson Medicine, Geriatrics and Palliative Care