Why do some people with Alzheimer's disease die without cognitive impairment, while others do? - Medical News Today

Since the time of Dr. Alois Alzheimer himself, two proteins (beta-amyloid (Aβ) and tau) have become tantamount to Alzheimer's disease
(AD). But a Mayo Clinic study challenges the perception that these are
the only important proteins accounting for the clinical features of the
devastating disease.
In a large clinico-imaging pathological study, Mayo Clinic researchers
demonstrated that a third protein (TDP-43) plays a major role in AD
pathology. In fact, people whose brain was TDP positive were 10 times
more likely to be cognitively impaired at death compared to those who
didn't have the protein, showing that TDP-43 has the potential to
overpower what has been termed resilient brain aging. The study was
published in the journal Acta Neuropathologica.

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