Study of neuropathological changes and dementia in 100 centenarians in The 90+ Study

INTRODUCTION The association between neuropathological changes and dementia among centenarians and nonagenarians remains unclear. METHODS We examined brain tissue from 100 centenarians and 297 nonagenarians from The 90+ Study, a community‐based longitudinal study of aging. We determined the prevalence of 10 neuropathological changes and compared their associations with dementia and cognitive performance between centenarians and nonagenarians. RESULTS A total of 59% of centenarians and 47% of nonagenarians had at least four neuropathological changes. In centenarians, neuropathological changes were associated with higher odds of dementia and, compared to nonagenarians, the odds were not attenuated. For each additional neuropathological change, the Mini‐Mental State Examination score was lower by 2 points for both groups. DISCUSSION Neuropathological changes continue to be strongly related to dementia in centenarians, highlighting the importance of slowing or preventing the development of multiple neuropathological changes in the aging brain to maintain cognitive health. Highlights Individual and multiple neuropathological changes are frequent in centenarians. These neuropathological changes are strongly associated with dementia. There is no attenuation of this association with age.