Individuals with dementia may come to forensic autopsy, partly because of non-natural deaths (e.g. fall-related), and/or concerns of abuse/neglect. At the New York City Office of Chief Medical Examiner (NYC OCME), brains from such cases are submitted for neurodegenerative disease (ND) work-up. Seventy-eight sequential cases were evaluated using a recently published condensed protocol for the NIA-AA guidelines for the neuropathologic assessment of Alzheimer disease (AD), a cost-cutting innovation in diagnostic neuropathology. ND was identified in 74 (94.9%) brains; the most common were AD (n = 41 [52.5%]), primary age-related tauopathy (n = 26 [33.3%]), and Lewy body disease ([LBD], n = 25 [32.1%]). Others included age-related tau astrogliopathy, hippocampal sclerosis of aging, progressive supranuclear palsy, multiple system atrophy, amyotrophic lateral sclerosis, argyrophilic grain disease, and Creutzfeldt-Jakob disease. 26.8% of AD cases involved a non-natural, dementia-related death, versus 40.0% for LBD. Finally, 70 (89.7%) cases had chronic cerebrovascular disease, 53 (67.9%) being moderate-to-severe. We present a diverse distribution of NDs notable for a high rate of diagnoses associated with falls (e.g. LBD), a potential difference from the hospital neuropathology experience. We also report a high burden of cerebrovascular disease in demented individuals seen at the NYC OCME. Finally, we demonstrate that the aforementioned condensed protocol is applicable for a variety of ND diagnoses.

中文翻译：

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法医环境中的痴呆症：在纽约市首席法医办公室使用浓缩方案获得的诊断

患有痴呆症的人可能会进行法医尸检，部分原因是非自然死亡（例如与跌倒有关）和/或对虐待/忽视的担忧。在纽约市首席法医办公室 (NYC OCME)，这些病例的大脑被提交用于神经退行性疾病 (ND) 的检查。使用最近发布的 NIA-AA 阿尔茨海默病 (AD) 神经病理学评估指南的精简方案评估了 78 个连续病例，这是诊断神经病理学中的一项成本削减创新。在 74 个 (94.9%) 的大脑中发现了 ND；最常见的是 AD (n = 41 [52.5%])、原发性年龄相关性 tauopathy (n = 26 [33.3%]) 和路易体病 ([LBD], n = 25 [32.1%])。其他包括与年龄相关的 tau 星形胶质细胞病、老化海马硬化、进行性核上性麻痹、多系统萎缩、肌萎缩侧索硬化症、嗜银粒病和克雅氏病。26.8% 的 AD 病例涉及非自然的、与痴呆相关的死亡，而 LBD 为 40.0%。最后，慢性脑血管病70例（89.7%），中重度53例（67.9%）。我们展示了 ND 的多样化分布，值得注意的是与跌倒相关的高诊断率（例如 LBD），这是与医院神经病理学经验的潜在差异。我们还报告了在 NYC OCME 看到的痴呆症患者的高脑血管疾病负担。最后，我们证明了上述精简协议适用于各种 ND 诊断。7%) 病例患有慢性脑血管疾病，53 例 (67.9%) 为中度至重度。我们展示了 ND 的多样化分布，值得注意的是与跌倒相关的高诊断率（例如 LBD），这是与医院神经病理学经验的潜在差异。我们还报告了在 NYC OCME 看到的痴呆症患者的高脑血管疾病负担。最后，我们证明了上述精简协议适用于各种 ND 诊断。7%) 病例患有慢性脑血管疾病，53 例 (67.9%) 为中度至重度。我们展示了 ND 的多样化分布，值得注意的是与跌倒相关的高诊断率（例如 LBD），这是与医院神经病理学经验的潜在差异。我们还报告了在 NYC OCME 看到的痴呆症患者的高脑血管疾病负担。最后，我们证明了上述精简协议适用于各种 ND 诊断。