Neuropathology of dementia with Lewy bodies in advanced age: A comparison with Alzheimer disease

▶ The severity of the neuropathology in the oldest old with DLB remains uncharacterized. ▶ We compared the characteristics of DLB cases divided into three age groups 70-79, 80-89 and ≥90 years (oldest old) to AD cases. ▶ Frequency and severity of DLB was lower in 80-89 and ≥90 year cases compared to the 70-79 year old group but cognitive impairment did not vary with age. ▶ The extent of AD neuropathology correlated with dementia severity only in the 70-79 year group, while synaptophysin immunoreactivity more strongly associated with dementia severity in the older age group in both DLB and AD. ▶ Our results suggest that the oldest old with DLB might represent a distinct group.