PT - JOURNAL ARTICLE AU - Trieu, Thomas AU - Sajjadi, Seyed Ahmad AU - Kawas, Claudia H. AU - Nelson, Peter T. AU - Corrada, María M. TI - Risk factors of hippocampal sclerosis in the oldest old AID - 10.1212/WNL.0000000000006455 DP - 2018 Nov 06 TA - Neurology PG - e1788--e1798 VI - 91 IP - 19 4099 - http://n.neurology.org/content/91/19/e1788.short 4100 - http://n.neurology.org/content/91/19/e1788.full SO - Neurology2018 Nov 06; 91 AB - Objective To examine the risk factors and comorbidities of hippocampal sclerosis (HS) in the oldest-old.Methods A total of 134 participants with dementia from The 90+ Study with longitudinal evaluations and autopsy were included in this investigation. Participants were divided into 2 groups, one with and one without HS pathology, and differences in clinical and pathologic characteristics were compared.Results Persons with HS tended to have a longer duration of dementia compared to participants without HS (mean 4.0 years vs 6.7 years, odds ratio [OR] 1.26; 95% confidence interval [CI] 1.11–1.42; p < 0.001). HS was more likely in participants with a history of autoimmune diseases (rheumatoid arthritis or thyroid disease, OR 3.15; 95% CI 1.30–7.62; p = 0.011), high thyroid-stimulating hormone (OR 4.94; 95% CI 1.40–17.46; p = 0.013), or high thyroid antibodies (OR 3.45; 95% CI 1.09–10.88; p = 0.035). Lewy body disease (LBD) pathology was also associated with an increased likelihood of HS (OR 5.70; 95% CI 1.22–26.4; p = 0.027).Conclusion We identified autoimmune conditions (rheumatoid arthritis and thyroid disease) as potential risk factors for HS in our cohort. LBD was the only pathology that was associated with increased odds of HS and those harboring HS pathology had a longer duration of dementia. This suggests multiple pathways of HS pathology among the oldest-old.CI=confidence interval; CVD=cerebrovascular disease; DSM-IV=Diagnostic and Statistical Manual of Mental Disorders, 4th edition; H&E=hematoxylin & eosin; HS=hippocampal sclerosis; LBD=Lewy body disease; OR=odds ratio; RA=rheumatoid arthritis; TPO=thyroid peroxidase; TSH=thyroid-stimulating hormone