A third of community-dwelling elderly with intermediate and high level of Alzheimer's neuropathologic changes are not demented: A meta-analysis

•We retrieved 17 population-based cohorts comprising 4677 subjects with brain autopsy.•Dementia proportion in subjects with tangles and/or plaques is between 0.52 and 0.84.•In a third of the elderly, dementia might not be associated with Alzheimer pathology.•In demented individuals, the probability of definitive Alzheimer pathology is 0.21–0.81.•In non-demented individuals, the probability of definitive Alzheimer pathology is 0.06–0.53.