Improvement of retinal tissue perfusion after circuit resistance training in healthy older adults.

PURPOSE: To determine the retinal tissue perfusion (RTP) and its relation to cognitive function in healthy older people after an 8-week high-speed circuit resistance training program (HSCT). METHODS: Eleven subjects in the HSCT group and seven age-matched non-training controls (CON) were recruited. The HSCT group trained 3 times per week for 8 weeks, while CON performed no formal training. One eye of each subject in both groups was imaged at baseline and at an 8-week follow-up, using a Retinal Function Imager to measure retinal blood flow (RBF). Retinal tissue perfusion (RTP) was calculated as RBF divided by the corresponding tissue volume. Cognitive function was assessed during both visits using the NIH Toolbox Fluid Cognition Battery. RESULTS: RTP was 2.99 ± 0.91 nl·s-1·mm-3 (mean ± SD) at baseline and significantly increased to 3.77 ± 0.86 nl·s-1·mm-3 after training (P < 0.001) in the HSCT group, reflecting an increase of 26%. In the HSCT group, the Pattern Comparison Processing Speed Test (PAT) and Fluid Cognition Composite Score (FCS) were significantly increased after HSCT (P = 0.01). Furthermore, the changes in Flanker Inhibitory Control and Attention Test (FLNK) were positively correlated to increases in RTP (r = 0.80, P = 0.003). CONCLUSIONS: This is the first prospective study to demonstrate that the increased RTP after HSCT was related to improved cognition in cognitively-normal elders, indicating RTP could be an imaging marker for monitoring cognitive changes due to physical activity in the elderly.

Amyloid burden accelerates white matter degradation in cognitively normal elderly individuals.

Alterations in parietal and temporal white matter microstructure derived from diffusion tensor imaging occur in preclinical and clinical Alzheimer's disease. Amyloid beta (Aß) deposition and such white matter alterations are two pathological hallmarks of Alzheimer's disease. However, the relationship between these pathologies is not yet understood, partly since conventional diffusion MRI methods cannot distinguish between cellular and extracellular processes. Thus, we studied Aß-associated longitudinal diffusion MRI changes in Aß-positive (N = 21) and Aß-negative (N = 51) cognitively normal elderly obtained from the Alzheimer's Disease Neuroimaging Initiative dataset using linear mixed models. Aß-positivity was based on Alzheimer's Disease Neuroimaging Initiative amyloid-PET recommendations using a standardized uptake value ratio cut-off of 1.11. We used free-water imaging to distinguish cellular and extracellular changes. We found that Aß-positive subjects had increased baseline right uncinate fasciculus free-water fraction (FW), associated with worse baseline Alzheimer's disease assessment scale scores. Furthermore, Aß-positive subjects showed faster decrease in fractional anisotropy (FW-corrected) in the right uncinate fasciculus and faster age-dependent right inferior longitudinal fasciculus FW increases over time. Right inferior longitudinal fasciculus FW increases were associated with greater memory decline. Importantly, these results remained significant after controlling for gray and white matter volume and hippocampal volume. This is the first study to illustrate the influence of Aß burden on early longitudinal (in addition to baseline) white matter changes in cognitively normal elderly individuals at-risk of Alzheimer's disease, thus underscoring the importance of longitudinal studies in assessing microstructural alterations in individuals at risk of Alzheimer's disease prior to symptoms onset.

Lower Late-Life Body-Mass Index is Associated with Higher Cortical Amyloid Burden in Clinically Normal Elderly.

BACKGROUND: Lower body-mass index (BMI) in late life has been associated with an increased risk of dementia, and weight loss has been associated with more rapid decline in Alzheimer's disease (AD) dementia. OBJECTIVE: To explore the association between BMI and cortical amyloid burden in clinically normal (CN) elderly at risk for AD dementia. METHODS: Cross-sectional analyses were completed using baseline data from the Harvard Aging Brain Study, consisting of 280 community-dwelling CN older adults aged 62-90. Assessments included medical histories and physical exam, Pittsburgh compound B (PiB) positron emission tomography (PET) amyloid imaging, and apolipoprotein E ɛ4 (APOE4) genotyping. For the primary analysis, a general linear regression model was used to evaluate the association of BMI with PiB retention. Covariates included age, sex, years of education, and APOE4 carrier status. Secondary analyses were performed for BMI subdivisions (normal, overweight, obese), APOE4 carriers, and BMI×APOE4 interaction. RESULTS: In the primary analysis, greater PiB retention was associated with lower BMI (ß â€Š=  -0.14, p = 0.02). In the secondary analyses, APOE4 carrier status (ß= -0.27, p = 0.02) and normal BMI (ß= -0.25, p = 0.01), as opposed to overweight or obese BMI, were associated with greater PiB retention. The BMI×APOE4 interaction was also significant (ß= -0.14, p = 0.04). CONCLUSIONS: This finding offers new insight into the role of BMI at the preclinical stage of AD, wherein lower BMI late in life is associated with greater cortical amyloid burden. Future studies are needed to elucidate the mechanism behind this association, especially in those with lower BMI who are APOE4 carriers.

Higher Prevalence of TDP-43 Proteinopathy in Cognitively Normal Asians: A Clinicopathological Study on a Multiethnic Sample.

Transactive response DNA binding protein 43 (TDP-43) proteinopathy is the major hallmark of frontotemporal lobar degeneration and amyotrophic lateral sclerosis. It is also present in a subset of Alzheimer's disease cases. Recently, few reports showed TDP-43 changes in cognitively normal elderly. In Caucasians, TDP-43 proteinopathy independently correlate with cognitive decline. However, it is challenging to establish direct links between cognitive and/or neuropsychiatric symptoms and protein inclusions in neurodegenerative diseases because individual cognitive reserves modify the threshold for clinical disease expression. Cognitive reserve is influenced by demographic, environmental and genetic factors. We investigated the relationships between demographic, clinical and neuropathological variables and TDP-43 proteinopathy in a large multiethnic sample of cognitively normal elderly. TDP-43 proteinopathy was identified in 10.5%, independently associated with older age (P = 0.03) and Asian ethnicity (P = 0.002). Asians showed a higher prevalence of TDP-43 proteinopathy than Caucasians, even after adjustment for sex, age, Braak stage and schooling (odds ratio = 3.50, confidence interval 1.41-8.69, P = 0.007). These findings suggested that Asian older adults may be protected from the clinical manifestation of brain TDP-43 proteinopathy. Future studies are needed to identify possible race-related protective factors against clinical expression of TDP-43 proteinopathies.

Identification of Conversion from Normal Elderly Cognition to Alzheimer's Disease using Multimodal Support Vector Machine.

Alzheimer's disease (AD) is one of the most serious progressive neurodegenerative diseases among the elderly, therefore the identification of conversion to AD at the earlier stage has become a crucial issue. In this study, we applied multimodal support vector machine to identify the conversion from normal elderly cognition to mild cognitive impairment (MCI) or AD based on magnetic resonance imaging and positron emission tomography data. The participants included two independent cohorts (Training set: 121 AD patients and 120 normal controls (NC); Testing set: 20 NC converters and 20 NC non-converters) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. The multimodal results showed that the accuracy, sensitivity, and specificity of the classification between NC converters and NC non-converters were 67.5% , 73.33% , and 64% , respectively. Furthermore, the classification results with feature selection increased to 70% accuracy, 75% sensitivity, and 66.67% specificity. The classification results using multimodal data are markedly superior to that using a single modality when we identified the conversion from NC to MCI or AD. The model built in this study of identifying the risk of normal elderly converting to MCI or AD will be helpful in clinical diagnosis and pathological research.

Amyloid burden in cognitively normal elderly is associated with preferential hippocampal subfield volume loss.

The earliest sites of brain atrophy in Alzheimer's disease are in the medial temporal lobe, following widespread cerebral cortical amyloid deposition. We assessed 74 cognitively normal participants with clinical measurements, amyloid-ß-PET imaging, MRI, and a newly developed technique for MRI-based hippocampal subfield segmentation to determine the differential association of amyloid deposition and hippocampal subfield volume. Compared to amyloid-negative participants, amyloid-positive participants had significantly smaller hippocampal tail, presubiculum, subiculum, and total hippocampal gray matter volumes. We conclude that, prior to the development of cognitive impairment, atrophy in particular hippocampal subfields occurs preferentially with amyloid-ß accumulation.

Beta-amyloid associated differential effects of APOE ε4 on brain metabolism in cognitively normal elderly.

OBJECTIVE: Although apolipoprotein (APOE) ε4 allele is a well-established risk factor for late-onset Alzheimer disease (AD), the mechanism of its effects on AD pathogenesis is not fully understood. We aimed to investigate the effects of APOE genotype on regional cerebral glucose metabolism in cognitively normal (CN) elderly. We further tried to elucidate whether or not such effects are associated with beta-amyloid protein (Aß) deposition. METHODS: 31 CN elderly participants underwent clinical examination, a range of neuropsychological tests, APOE genotyping, and Pittsburgh compound-B- and fluorodeoxyglucose-PET scans. RESULTS: 17 APOE ε4 carriers and 15 non-carriers were included. Both hypometabolic and hypermetabolic regions were observed in ε4 carriers compared with noncarriers when age, education, and sex were controlled. When the degree of global cerebral Aß deposition was adjusted, the hypometabolic regions in the temporo-parietal area (i.e., BA 22 and 39) largely disappeared, whereas the hypermetabolic regions persisted in medial frontal and anterior temporal areas (i.e., BA 38, 11, and 39). Behaviorally, verbal episodic memory scores of APOE ε4 carriers were slightly lower than those of noncarriers, though still within normal range. CONCLUSIONS: Our findings indicate that decreased cerebral glucose metabolism in the temporoparietal junction associated with APOE ε4 in CN elderly appears to be mediated by Aß deposition, and the effect of APOE ε4 on hypermetabolism in the frontal and anterior temporal regions is independent of Aß and may be associated with presence of compensatory mechanism in CN elderly with the ε4 allele.

Characteristics of Language Comprehension in Normal Elderly and the Mild Cognitive Impaired

BACKGROUND: Healthy aging is characterized by declines in language function and it is important to differentiate language comprehension difficulties due to pathological aging (i.e., mild cognitive impairment) from those due to normal aging. The purposes of this study were to review the literature on characteristics of language comprehension in normal elderly and the mild cognitive impaired, and to compare their performances on different language domains. METHODS: A comprehensive literature search identified numerous studies on language comprehension in both groups, and we analyzed them according to each language domain. RESULTS: The results indicated that the normal elderly show more difficulties in the comprehension of grammatically or lexically complex sentences and in text/discourse comprehension than words or simple sentences. Compared to normal elderly, MCI shows significantly lower performance on text/discourse comprehension and other tasks demanding higher cognitive function. In both groups, there are many different factors affecting language comprehension, such as hearing sensitivity, speech rate, literacy, and cognition. CONCLUSIONS: The results may provide insight into useful language comprehension tasks for differential diagnosis between normal aging and MCI. Further research on various compensatory strategies in daily life to facilitate language comprehension for both groups is warranted.

Amyloid imaging in cognitively normal individuals, at-risk populations and preclinical Alzheimer's disease.

Recent developments of PET amyloid ligands have made it possible to visualize the presence of Aß deposition in the brain of living participants and to assess the consequences especially in individuals with no objective sign of cognitive deficits. The present review will focus on amyloid imaging in cognitively normal elderly, asymptomatic at-risk populations, and individuals with subjective cognitive decline. It will cover the prevalence of amyloid-positive cases amongst cognitively normal elderly, the influence of risk factors for AD, the relationships to cognition, atrophy and prognosis, longitudinal amyloid imaging and ethical aspects related to amyloid imaging in cognitively normal individuals. Almost ten years of research have led to a few consensual and relatively consistent findings: some cognitively normal elderly have Aß deposition in their brain, the prevalence of amyloid-positive cases increases in at-risk populations, the prognosis for these individuals is worse than for those with no Aß deposition, and significant increase in Aß deposition over time is detectable in cognitively normal elderly. More inconsistent findings are still under debate; these include the relationship between Aß deposition and cognition and brain volume, the sequence and cause-to-effect relations between the different AD biomarkers, and the individual outcome associated with an amyloid positive versus negative scan. Preclinical amyloid imaging also raises important ethical issues. While amyloid imaging is definitely useful to understand the role of Aß in early stages, to define at-risk populations for research or for clinical trial, and to assess the effects of anti-amyloid treatments, we are not ready yet to translate research results into clinical practice and policy. More researches are needed to determine which information to disclose from an individual amyloid imaging scan, the way of disclosing such information and the impact on individuals and on society.

The generation of visualinferences in normal elderly - Influence of schooling and visual complexity / A geração de inferências visuais em idosos normais - influência da escolaridade e complexidade visual

The generation of inferences makes the construction and comprehension of discourse easier, and integrates representations which add coherence to the arguments. Visuoperceptual and inferential deficits merge in the attempt to explain the difficulties that some individuals have in the comprehension of certain kinds of visual stimuli. Objectives: a) To examine the performance of cognitively healthy elderly subjects in the execution of visual inferences using pictures of different levels of complexity; b) To compare the performance of subjects according to schooling level. Methods: A total of 45 normal elderly aged from 61 to 82yrs (M=68; SD=0.57) were examined. The subjects were divided into three groups according to schooling level: Group 1 (1 to 4 years); Group 2 (5 to 8 years) and Group 3 (9 or more years). Each subject had to create a narrative based on four figures with controlled visual complexity. The narratives were transcribed, analysed and scored. Results: For the essential inferences, the high educated group (3) had a better performance in both visually simple and complex conditions. On the visually complex figures, the medium educated group (2) was statistically equivalent to the high educated group for one figure and equivalent to the less educated group (1) for the other. There was no difference among the groups for the accessory propositions. Conclusions: Visual complexity interferes with the subject?s ability to make inferences in low and medium educated individuals. High educated subjects maintain the same performance in making inferences, regardless of the visual complexity level.

A geração de inferências facilita a construção e a compreensão do discurso, e integra representações que dão maior coerência aos argumentos. Os déficits visuoperceptuais e inferenciais confundem-se na tentativa de explicar as dificuldades de alguns indivíduos em compreender alguns tipos de estímulos visuais. Objetivos:a) Investigar o desempenho de indivíduos idosos normais, na realização de inferências visuais, a partir de figuras de diferentes graus de complexidade visual; b) Comparar o desempenho dos sujeitos de acordo com os níveis de escolaridade. Métodos: Foram examinados 45 idosos normais com idades entre 61 e 82 anos (M=68; DP=0.57). Constituiu-se 3 grupos segundo nível de escolaridade: grupo 1 (de 1 a 4 anos); grupo 2 (de 5 a 8 anos) e grupo 3 (9 ou mais anos). A cada indivíduo foram apresentadas 4 figuras, com graus de complexidade visuoespacial controlados para elaboração de discurso. Os itens colhidos foram transcritos, analisados e pontuados. Resultados: No que diz respeito às proposições essenciais, o grupo de maior escolaridade (3) apresentou melhor desempenho na descrição de ambas as figuras (simples e complexas). Nas figuras visualmente complexas, o grupo com escolaridade média (2) apresentou resultados estatisticamente equivalente ao grupo de alta escolaridade para uma figura e resultado estatisticamente equivalente ao grupo de menor escolaridade (1) para outra figura. Em relação às informações acessórias, não houve diferenças entre os grupos. Conclusões: A complexidade visual interfere na capacidade de realizar inferências nos indivíduos com baixa e média escolaridade. Indivíduos com alta escolaridade mantêm o mesmo desempenho na realização de inferências, independentemente do grau de complexidade das figuras.

The generation of visual inferences in normal elderly- Influence of schooling and visual complexity.

The generation of inferences makes the construction and comprehension of discourse easier, and integrates representations which add coherence to the arguments. Visuoperceptual and inferential deficits merge in the attempt to explain the difficulties that some individuals have in the comprehension of certain kinds of visual stimuli. OBJECTIVES: a) To examine the performance of cognitively healthy elderly subjects in the execution of visual inferences using pictures of different levels of complexity;b) To compare the performance of subjects according to schooling level. METHODS: A total of 45 normal elderly aged from 61 to 82yrs (M=68; SD=0.57) were examined. The subjects were divided into three groups according to schooling level: Group 1 (1 to 4 years); Group 2 (5 to 8 years) and Group 3 (9 or more years). Each subject had to create a narrative based on four figures with controlled visual complexity. The narratives were transcribed, analysed and scored. RESULTS: For the essential inferences, the high educated group (3) had a better performance in both visually simple and complex conditions. On the visually complex figures, the medium educated group (2) was statistically equivalent to the high educated group for one figure and equivalent to the less educated group (1) for the other. There was no difference among the groups for the accessory propositions. CONCLUSIONS: Visual complexity interferes with the subject's ability to make inferences in low and medium educated individuals. High educated subjects maintain the same performance in making inferences, regardless of the visual complexity level.

A geração de inferências facilita a construção e a compreensão do discurso, e integra representações que dão maior coerência aos argumentos. Os déficits visuoperceptuais e inferenciais confundem-se na tentativa de explicar as dificuldades de alguns indivíduos em compreender alguns tipos de estímulos visuais. OBJETIVOS: a) Investigar o desempenho de indivíduos idosos normais, na realização de inferências visuais, a partir de figuras de diferentes graus de complexidade visual;b) Comparar o desempenho dos sujeitos de acordo com os níveis de escolaridade. MÉTODOS: Foram examinados 45 idosos normais com idades entre 61 e 82 anos (M=68; DP=0.57). Constituiu-se 3 grupos segundo nível de escolaridade: grupo 1 (de 1 a 4 anos); grupo 2 (de 5 a 8 anos) e grupo 3 (9 ou mais anos). A cada indivíduo foram apresentadas 4 figuras, com graus de complexidade visuoespacial controlados para elaboração de discurso. Os itens colhidos foram transcritos, analisados e pontuados. RESULTADOS: No que diz respeito às proposições essenciais, o grupo de maior escolaridade (3) apresentou melhor desempenho na descrição de ambas as figuras (simples e complexas). Nas figuras visualmente complexas, o grupo com escolaridade média (2) apresentou resultados estatisticamente equivalente ao grupo de alta escolaridade para uma figura e resultado estatisticamente equivalente ao grupo de menor escolaridade (1) para outra figura. Em relação às informações acessórias, não houve diferenças entre os grupos. CONCLUSÕES: A complexidade visual interfere na capacidade de realizar inferências nos indivíduos com baixa e média escolaridade. Indivíduos com alta escolaridade mantêm o mesmo desempenho na realização de inferências, independentemente do grau de complexidade das figuras.

Síndrome de Charles Bonnet: a propósito de um caso / Charles Bonnet syndrome: regarding a case

Idosos com déficit visual por vezes apresentam alucinações visuais relacionadas à síndrome de Charles Bonnet. O surgimento destas alucinoses frequentemente causa ansiedade ao paciente e gera dificuldade diagnóstica e de conduta. Neste artigo descrevemos o caso de uma senhora de 82 anos de idade que se queixou de alucinações visuais complexas e revimos a literatura a respeito da síndrome de Charles Bonnet; condição que promove alucinação visual em pessoas mentalmente saudáveis.

Visually handicapped elderly people sometimes experience visual hallucinations associated with Charles Bonnet syndrome. The appearance of these hallucinosis often causes anxiety to the sufferer and can be difficult for the diagnosis and management. In this article, we report an 82-year-old woman that suddenly complained of complex visual hallucinations, and review the literature on the Charles Bonnet syndrome, a condition involving visual hallucinations in a mentally normal person.

Relationship of Sleep Factors with Neurocognitive Function in Normal Elderly Subjects and Mild Cognitive Impairment (MCI) Patients / 신경정신의학

OBJECTIVES: We aimed to compare sleep factors including daytime sleepiness, sleep apnea and insomnia between mild cognitive impairment (MCI) patients and normal control (NC) subjects and to illustrate their relationship with neuropsychological function in the preclinical stage of dementia. METHODS: Epworth Sleepiness Scale (ESS), sleep apnea subscale of Sleep Disorders Questionnaire (SA) and questionnaire on insomnia were administered to community-dwelling elderly subjects above the age of 60. Both clinical and neuropsychological batteries of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) assessment packet and Stroop Color and Word Test (SCWT) were done for each subject. Seventy seven NC subjects and 47 MCI patients were selected. RESULTS: In the NC group, ESS scores negatively correlated with Stroop interference (SI) scores. SA scores were negatively correlated with Stroop Color Word (SCW) and SI scores. In the MCI group, ESS scores negatively correlated with SCW scores, and SA scores had no correlation with each neurocognitive function test. CONCLUSION: Daytime sleepiness was associated with impaired executive function in community-dwelling normal elderly subjects and MCI patients. But the higher risk of SA was associated with decreased executive function only in normal elderly subjects.

Attitudes toward Disclosing Dementia Diagnosis in Korean Elderly and Family with Dementia Patients

OBJECTIVES: The aims of this study were to know whether Korean healthy elderly and family with dementia patients were wishing to disclose the diagnosis of dementia, to identify reasons of their wishing and unwishing to disclose, and to analyze influencing factors on the disclosing of dementia. METHODS: We obtained data from 78 healthy elderly with age over 60 and 73 family with dementia patients by interviewing with questionnaire about attitudes toward disclosing dementia. RESULTS: 1) 51.3% of healthy elderly and 58.9% of family with dementia patients were wishing to disclose dementia. Other relatives whom they wanted to tell were spouse or adult children. Most family with dementia patients wanted to have predictive tests in preparation for their future. 2) The main reasons for wishing to disclose were to make advance planning in healthy elderly, and to be careful and cooperate well to treat if they aware their illness in family with dementia patients (p<0.005, respectively). The main reasons for unwishing to disclose were whether they might be frightened or upset in healthy elderly (p<0.025), and to worry about being depressed in family with dementia patients (p<0.005). The main reasons why family wanted to be told were family's right to know and to explore treatment options. 3) The influencing factors on disclosing dementia seemed to be sex (p<0.01) and marital status (p<0.005) in healthy elderly, and education (p<0.005), marital status (p<0.005), religion (p<0.025) and socioeconomic status (p<0.01). CONCLUSION: The attitude toward disclosing diagnosis of dementia in Korean healthy elderly and family with dementia patients seemed to be more active. Therefore, doctors should prepare in mental attitude and knowledge to satisfy their need by active provision of information and education.

The Frequency of Serum Autoantibodies to the Epidermal Antigens among Normal Elderly People / 대한피부과학회지

BACKGROUND: One of the age-associated changes in immunity is the increase of autoantibodies due to dysregulation of the immune function. Anti-basement membrane zone antibodies were also reported to be found in the sera taken from normal elderly people. OBJECTIVE: The purpose of this study is to examine the frequency of autoantibodies to the epidermal antigens in the sera among normal elderly people. METHODS:Indirect immunofluorescence using salt-split human skin and immunoblotting with extracts from epidermoid carcinoma cell line(A431) were performed using sera from forty elderly persons without any systemic disease. RESULTS: Among 40 elderly individuals, 3 cases(7.5%) were positive for anti-basement membrane zone IgG antibodies in indirect immunofluorescence, and the titers were 1:10 to 1:40 dilution factor. In immunoblottings, 4 cases(10%) were positive with epidermal antigens; 2 were positive against the 180kD protein with IgG and IgA autoantibodies, 1 showed positive bands at 230kD and 180kD antigens with IgG, and remaining one showed positive at 130kD antigen who had negative result in indirect immunofluorescence. CONCLUSION: Autoantibodies against epidermal antigens(bullous pemphigoid angigen[230/180kD] or pemphigus vulgaris antigen[130kD]) can be detected without any bullous cutaneous diseases among elderly people; possibly as an epiphenomenon of immunosenescence.

The Frequency of Serum Autoantibodies to the Epidermal Antigens among Normal Elderly People / 대한피부과학회지

BACKGROUND: One of the age-associated changes in immunity is the increase of autoantibodies due to dysregulation of the immune function. Anti-basement membrane zone antibodies were also reported to be found in the sera taken from normal elderly people. OBJECTIVE: The purpose of this study is to examine the frequency of autoantibodies to the epidermal antigens in the sera among normal elderly people. METHODS:Indirect immunofluorescence using salt-split human skin and immunoblotting with extracts from epidermoid carcinoma cell line(A431) were performed using sera from forty elderly persons without any systemic disease. RESULTS: Among 40 elderly individuals, 3 cases(7.5%) were positive for anti-basement membrane zone IgG antibodies in indirect immunofluorescence, and the titers were 1:10 to 1:40 dilution factor. In immunoblottings, 4 cases(10%) were positive with epidermal antigens; 2 were positive against the 180kD protein with IgG and IgA autoantibodies, 1 showed positive bands at 230kD and 180kD antigens with IgG, and remaining one showed positive at 130kD antigen who had negative result in indirect immunofluorescence. CONCLUSION: Autoantibodies against epidermal antigens(bullous pemphigoid angigen[230/180kD] or pemphigus vulgaris antigen[130kD]) can be detected without any bullous cutaneous diseases among elderly people; possibly as an epiphenomenon of immunosenescence.