Senile plaques do not progressively accumulate with normal aging

Senile plaques (SP) are one of the pathologic hallmarks of Alzheimer's disease (AD). Models of SP formation, particularly the early stages, could provide valuable insight into AD pathogenesis. One such model may be provided by non-demented elderly individuals in whom some SP are a common incidental finding. This study has examined post-mortem brain tissue from a large number of such neurologically normal patients in an attempt to better understand the temporal sequence of SP formation. SP were identified in modified Bielschowsky-stained sections of mesial temporal lobe in 122 (30%) of 402 cases. The prevalence of SP in the temporal neocortex correlated strongly with patient age. Surprisingly, however, neither the mean nor maximum SP density showed any increase with age. This suggests that SP do not progressively accumulate in normal aging but develop over a limited time period after which their number stabilizes at a constant level. In most cases, all SP were of the diffuse type. In 37 cases (9%), however, some neuritic SP (NP) were also seen. Although the NP density did not show a significant increase with age either, the proportion of SP which were neuritic (NP/SP), did. This suggests that changes in SP morphology may be more important than total SP numbers in normal aging.