Indian Journal of PsychiatryIndian Journal of Psychiatry
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ORIGINAL ARTICLE
Year : 2017  |  Volume : 59  |  Issue : 4  |  Page : 471-477

Early stages of Alzheimer's disease are alarming signs in injury deaths caused by traffic accidents in elderly people (≥60 years of age): A neuropathological study


1 Department of Anatomy, Faculty of Medical Sciences, Genetic Diagnostic Research Laboratory and Human Brain Bank Tissue Repository, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
2 School of Medical and Molecular Biosciences, University of Technology Sydney, Sydney, Australia
3 Nonclinical Biostatistics, Janssen Research and Development (Retired), Raritan, USA
4 Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
5 Departments of Forensic Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
6 Department of Judicial Medical Office, Colombo South Teaching Hospital, Colombo, Sri Lanka
7 Department of Pathology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
8 Department of Pharmacology, College of Medicine, Seoul National University, Seoul, South Korea
9 Department of Translational Neuroscience, Faculty Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands

Correspondence Address:
Prof. K Ranil D. De Silva
Department of Anatomy, Faculty of Medical Sciences, Genetic Diagnostic and Research Laboratory and Human Brain Bank Tissue Repository, University of Sri Jayewardenepura, Nugegoda 10250
Sri Lanka
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/psychiatry.IndianJPsychiatry_102_16

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Background: There is little information available in the literature concerning the contribution of dementia in injury deaths in elderly people (≥60 years). Aim: This study was intended to investigate the extent of dementia-related pathologies in the brains of elderly people who died in traffic accidents or by suicide and to compare our findings with age- and sex-matched natural deaths in an elderly population. Materials and Methods: Autopsy-derived human brain samples from nine injury death victims (5 suicide and 4 traffic accidents) and nine age- and sex-matched natural death victims were screened for neurodegenerative and cerebrovascular pathologies using histopathological and immunohistochemical techniques. For the analysis, Statistical Package for the Social Sciences (SPSS) version 16.0 was used. Results: There was a greater likelihood for Alzheimer's disease (AD)-related changes in the elders who succumbed to traffic accidents (1 out of 4) compared to age- and sex-matched suicides (0 out of 5) or natural deaths (0 out of 9) as assessed by the National Institute on Aging – Alzheimer's Association guidelines. Actual burden of both neurofibrillary tangles (NFTs) and (SPs) was comparatively higher in the brains of traffic accidents, and the mean NFT counts were significantly higher in the region of entorhinal cortex (P < 0.05). However, associations obtained for other dementia-related pathologies were not statistically important. Conclusion: Our findings suggest that early Alzheimer stages may be a contributing factor to injury deaths caused by traffic accidents in elderly people whereas suicidal brain neuropathologies resembled natural deaths.



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