Mixed brain pathologies in dementia: The BrainNet Europe consortium experience

Gabor G. Kovacs, Irina Alafuzoff, Safa Al-Sarraj, Thomas Arzberger, Nenad Bogdanovic, Sabina Capellari, Isidro Ferrer, Ellen Gelpi, Viktor Kövari, Hans Kretzschmar, Zoltan Nagy, Piero Parchi, Danielle Seilhean, Hilkka Soininen, Claire Troakes, Herbert Budka

Research output: Contribution to journalArticlepeer-review


Background: Dementia results from heterogeneous diseases of the brain. Mixed disease forms are increasingly recognized. Methods: We performed a survey within brain banks of BrainNet Europe to estimate the proportion of mixed disease forms underlying dementia and age- and gender-specific influences. Results: Data collected in 9 centres from 3,303 individuals were analysed. The proportion of patients with mixed diagnoses among all cases with Alzheimer disease (AD), vascular pathology (VP), argyrophilic grain dementia (AGD), and synucleinopathies, such as Lewy body dementia (LBD), Parkinson disease (PD) and synuclein pathology only in the amygdala, was 53.3%. Mixed pathology was more frequently reported with LBD, PD, AGD, and VP than with AD. The percentage of mixed diagnoses for AGD and VP significantly differed between centres. In patients younger than 75 years, synucleinopathies, and pure forms of AD, VP, and AGD were more frequent in men. Above 75 years of age, more women had pure AD and pure AGD. Conclusions: The most obvious neuropathological alteration should not terminate the diagnostic procedure since copathology is likely to be found. Neuropathological interpretation of AGD and VP has not been sufficiently established in a consensus. Pure forms of synucleinopathies are unlikely sole substrates for dementia.

Original languageEnglish
Pages (from-to)343-350
Number of pages8
JournalDementia and Geriatric Cognitive Disorders
Issue number4
Publication statusPublished - Oct 2008


  • Alzheimer disease
  • Argyrophilic grain dementia
  • Synucleinopathy
  • Vascular pathology

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Cognitive Neuroscience


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