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At last evaluation, 35% had dementia, 23% cognitive impairment, and 41% normal cognition. 35.5% had intermediate AD, 8.1% had high AD neuropathologic changes, 73% had moderate\/severe arteriolosclerosis, 23%\u00a0one or more microinfarcts, 32% Lewy bodies, 24% TDP\u201043 deposits, and 4% hippocampal sclerosis. There was a high degree of mixed neuropathology, with 69% having\u00a0three or more pathologies. Cognitive impairment was most strongly associated with AD pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Multiple pathologies were common, and many individuals maintained normal cognition indicating substantial neuropathologic burden may be present in the absence of overt cognitive impairment, especially in the oldest\u2010old.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.71634","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:05:42Z","timestamp":1784955942000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Neuropathology in a diverse cohort of oldest\u2010old: The LifeAfter90 study"],"prefix":"10.1002","volume":"22","author":[{"given":"Brittany N.","family":"Dugger","sequence":"first","affiliation":[{"name":"University of California Davis  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie N.","family":"Luu","sequence":"additional","affiliation":[{"name":"University of California Davis  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viharkumar","family":"Patel","sequence":"additional","affiliation":[{"name":"University of California Davis  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"DeCarli","sequence":"additional","affiliation":[{"name":"University of California Davis  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee\u2010Way","family":"Jin","sequence":"additional","affiliation":[{"name":"University of California Davis  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Gilsanz","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northern California, Division of Research  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Mungas","sequence":"additional","affiliation":[{"name":"University of California Davis  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Kawas","sequence":"additional","affiliation":[{"name":"University of California, Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria M.","family":"Corrada","sequence":"additional","affiliation":[{"name":"University of California, Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel A.","family":"Whitmer","sequence":"additional","affiliation":[{"name":"University of California Davis  Sacramento California USA"},{"name":"Kaiser Permanente Northern California, Division of Research  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"U.S. Census Bureau.2023 National Population Projections Projected Population by Single Year of Age Sex Race and Hispanic Origin for the United States: 2022 to 2100. 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