Neuropathological diagnoses and age-related differences in Finnish medico-legal autopsies of individuals aged 65 years and older.

Authors

Emma Pellikka, Paula K Vauhkonen, Petteri Oura

Published in

Forensic science, medicine, and pathology. Sep 17, 2026. Epub Sep 17, 2026.

Abstract

As populations worldwide continue to grow older, an increase in cases involving aged individuals is also to be expected in medico-legal autopsies. The aim of this study was to report the neuropathological diagnoses of individuals aged ≥ 65 years, and to compare the findings across three age groups: youngest-olds (65-74 years of age), middle-olds (75-84) and oldest-olds (≥ 85). The sample comprised all Finnish medico-legal autopsies of individuals aged ≥ 65 years whose autopsy included a full neuropathological examination performed by a neuropathologist over the period 2016-2022 (n = 629). Neuropathological diagnoses were obtained from the neuropathologists' reports, and background characteristics were collected from medico-legal cause-of-death investigation documents. Of all cases, 97.1% received at least one neuropathological diagnosis. The prevalences of many neurodegenerative diseases increased with age; Alzheimer's disease neuropathological change (30.5%) and cerebral amyloid angiopathy (14.0%) were the most common ones. However, some rarer neurodegenerative diseases were more frequent among youngest-olds. While the prevalence of acute infarcts remained relatively consistent across the age groups (12.4-14.5%), old infarcts and subarachnoid haemorrhages were most common among oldest-olds (22.1% and 16.6%, respectively). The age-related increase in subarachnoid haemorrhage diagnoses appeared to be primarily driven by the male sex. The prevalences of acute and old traumatic brain injuries were rather low (5.7-6.2% and 5.1%, respectively) and remained relatively stable across the age groups. In conclusion, our data suggest that neuropathological diagnoses are highly prevalent among aged individuals undergoing medico-legal autopsy, and many diagnoses become more frequent towards oldest-olds.

PMID:
42753051
Bibliographic data and abstract were imported from PubMed on 18 Sep 2026.

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