{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T17:42:31Z","timestamp":1775497351056,"version":"3.50.1"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000002","name":"National institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neuropathol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Although intermediate\/high Alzheimer\u2019s Disease Neuropathologic Change (ADNC) is associated with dementia in many older adults, some remain cognitively normal and are often referred to as resilient to ADNC. We aim to examine health, lifestyle, and neuropathologic factors that distinguish older adults with dementia vs. normal cognition in the presence of intermediate\/high ADNC. Participants were from\n                    <jats:italic>The 90<\/jats:italic>\n                    \u2009+\u2009\n                    <jats:italic>Study<\/jats:italic>\n                    , a longitudinal study of aging in southern California. This cross-sectional analysis included participants with an intermediate\/high ADNC on neuropathologic exam and normal cognition or dementia diagnosis on case conference. We analyzed 11 neuropathologic changes, both vascular and neurodegenerative, dichotomized as present\/absent, and the total number of neuropathologies. To examine the association of health and lifestyle factors and neuropathologic changes (predictors) with cognitive diagnosis at consensus case conference, dementia vs. normal cognition, (outcome), we used logistic regression adjusted for demographics. Among 235 participants (mean age at death\u2009=\u200998\u00a0years, 70% women), 33% maintained normal cognition. Participants with heart disease (OR\u2009=\u20090.45; 95% CI\u2009=\u20090.25, 0.81) and hypertension (OR\u2009=\u20090.53; 95% CI\u2009=\u20090.29, 0.95) had lower likelihood of dementia. In contrast, participants with a history of transient ischemic attacks (OR\u2009=\u20093.00; 95% CI\u2009=\u20091.46, 6.18), Lewy Body Disease (OR\u2009=\u20092.73; 95% CI\u2009=\u20091.14, 6.58), hippocampal sclerosis (OR\u2009=\u20092.70; 95% CI\u2009=\u20091.06, 6.86), Limbic-predominant Age-related TDP-43 Encephalopathy neuropathologic change (OR\u2009=\u20092.80; 95% CI\u2009=\u20091.53, 5.12), and a high number of non-ADNCs (OR\u2009=\u20094.46; 95% CI\u2009=\u20092.01, 9.92) had higher likelihood of dementia. Arteriolosclerosis, atherosclerosis, cerebral amyloid angiopathy, and microvascular lesions were not associated with dementia. In this study, the presence of neurodegenerative neuropathologic changes other than ADNC and the absence of hypertension distinguish oldest old individuals with dementia from those with normal cognition. Understanding mechanisms underlying normal cognition in those with ADNC may provide important clues to prevention and resilience to the effects of AD neuropathology.\n                  <\/jats:p>","DOI":"10.1007\/s00401-026-03010-9","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T16:16:23Z","timestamp":1775492183000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Contribution of health history and neuropathologic changes to the likelihood of dementia in those with intermediate\/high Alzheimer\u2019s pathology: findings from The 90\u2009+\u2009Study"],"prefix":"10.1007","volume":"151","author":[{"given":"Zarui A.","family":"Melikyan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeinah","family":"Al-darsani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luohua","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine A.","family":"Colcord","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annlia","family":"Paganini-Hill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed A.","family":"Bukhari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas J.","family":"Montine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia H.","family":"Kawas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda M.","family":"Corrada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"3010_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbas.2023.100065","volume":"3","author":"N Ahangari","year":"2023","unstructured":"Ahangari N, Fischer CE, Schweizer TA, Munoz DG (2023) Cognitive resilience and severe Alzheimer\u2019s disease neuropathology. Aging Brain 3:100065. https:\/\/doi.org\/10.1016\/j.nbas.2023.100065","journal-title":"Aging Brain"},{"key":"3010_CR2","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.3233\/JAD-180942","volume":"68","author":"EJ Aiello Bowles","year":"2019","unstructured":"Aiello Bowles EJ, Crane PK, Walker RL, Chubak J, LaCroix AZ, Anderson ML et al (2019) Cognitive resilience to Alzheimer\u2019s disease pathology in the human brain. J Alzheimers Dis 68:1071\u20131083. https:\/\/doi.org\/10.3233\/JAD-180942","journal-title":"J Alzheimers Dis"},{"key":"3010_CR3","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"1994","unstructured":"American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders. American Psychiatric Association, Washington, DC"},{"key":"3010_CR4","doi-asserted-by":"publisher","first-page":"2066","DOI":"10.1212\/wnl.54.11.2066","volume":"54","author":"JC Anthony","year":"2000","unstructured":"Anthony JC, Breitner JC, Zandi PP, Meyer MR, Jurasova I, Norton MC et al (2000) Reduced prevalence of AD in users of NSAIDs and H2 receptor antagonists: the Cache County study. Neurology 54:2066\u20132071. https:\/\/doi.org\/10.1212\/wnl.54.11.2066","journal-title":"Neurology"},{"key":"3010_CR5","doi-asserted-by":"publisher","first-page":"5695","DOI":"10.1002\/alz.13844","volume":"20","author":"EM Arenaza-Urquijo","year":"2024","unstructured":"Arenaza-Urquijo EM, Boyle R, Casaletto K, Anstey KJ, Vila-Castelar C, Colverson A et al (2024) Sex and gender differences in cognitive resilience to aging and Alzheimer\u2019s disease. Alzheimers Dement 20:5695\u20135719. https:\/\/doi.org\/10.1002\/alz.13844","journal-title":"Alzheimers Dement"},{"key":"3010_CR6","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.brainres.2019.05.028","volume":"1719","author":"LL Barnes","year":"2019","unstructured":"Barnes LL, Lamar M, Schneider JA (2019) Sex differences in mixed neuropathologies in community-dwelling older adults. Brain Res 1719:11\u201316. https:\/\/doi.org\/10.1016\/j.brainres.2019.05.028","journal-title":"Brain Res"},{"key":"3010_CR7","doi-asserted-by":"publisher","first-page":"1837","DOI":"10.1212\/01.wnl.0000219668.47116.e6","volume":"66","author":"DA Bennett","year":"2006","unstructured":"Bennett DA, Schneider JA, Arvanitakis Z, Kelly JF, Aggarwal NT, Shah RC et al (2006) Neuropathology of older persons without cognitive impairment from two community-based studies. Neurology 66:1837\u20131844. https:\/\/doi.org\/10.1212\/01.wnl.0000219668.47116.e6","journal-title":"Neurology"},{"key":"3010_CR8","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1007\/BF00308809","volume":"82","author":"H Braak","year":"1991","unstructured":"Braak H, Braak E (1991) Neuropathological stageing of Alzheimer-related changes. Acta Neuropathol 82:239\u2013259. https:\/\/doi.org\/10.1007\/BF00308809","journal-title":"Acta Neuropathol"},{"key":"3010_CR9","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.maturitas.2011.07.008","volume":"70","author":"C Brumback-Peltz","year":"2011","unstructured":"Brumback-Peltz C, Balasubramanian AB, Corrada MM, Kawas CH (2011) Diagnosing dementia in the oldest-old. Maturitas 70:164\u2013168. https:\/\/doi.org\/10.1016\/j.maturitas.2011.07.008","journal-title":"Maturitas"},{"key":"3010_CR10","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.jalz.2016.09.007","volume":"13","author":"MM Corrada","year":"2017","unstructured":"Corrada MM, Hayden KM, Paganini-Hill A, Bullain SS, DeMoss J, Aguirre C et al (2017) Age of onset of hypertension and risk of dementia in the oldest-old: The 90+ Study. Alzheimers Dement 13:103\u2013110. https:\/\/doi.org\/10.1016\/j.jalz.2016.09.007","journal-title":"Alzheimers Dement"},{"key":"3010_CR11","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1016\/j.jalz.2016.04.006","volume":"12","author":"MM Corrada","year":"2016","unstructured":"Corrada MM, Sonnen JA, Kim RC, Kawas CH (2016) Microinfarcts are common and strongly related to dementia in the oldest-old: the 90+ study. Alzheimers Dement 12:900\u2013908. https:\/\/doi.org\/10.1016\/j.jalz.2016.04.006","journal-title":"Alzheimers Dement"},{"key":"3010_CR12","doi-asserted-by":"crossref","unstructured":"Culhane JE, Mock C, Chen KCG, Chen Y-C, Kukull WA (2023) Resistance and resilience to Alzheimer\u2019s disease pathologyassociated with lower severity of other neuropathologicdiseases. In: Alzheimer's Association International Conference, Amsterdan, Netherlands. Alzheimer's and Dementia","DOI":"10.1002\/alz.067891"},{"key":"3010_CR13","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1017\/S1355617710001426","volume":"17","author":"NM Dowling","year":"2011","unstructured":"Dowling NM, Tomaszewski Farias S, Reed BR, Sonnen JA, Strauss ME, Schneider JA et al (2011) Neuropathological associates of multiple cognitive functions in two community-based cohorts of older adults. J Int Neuropsychol Soc 17:602\u2013614. https:\/\/doi.org\/10.1017\/S1355617710001426","journal-title":"J Int Neuropsychol Soc"},{"key":"3010_CR14","doi-asserted-by":"publisher","first-page":"1793","DOI":"10.1016\/S0140-6736(97)01007-6","volume":"349","author":"JE Graham","year":"1997","unstructured":"Graham JE, Rockwood K, Beattie BL, Eastwood R, Gauthier S, Tuokko H et al (1997) Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet 349:1793\u20131796. https:\/\/doi.org\/10.1016\/S0140-6736(97)01007-6","journal-title":"Lancet"},{"key":"3010_CR15","doi-asserted-by":"publisher","first-page":"2316","DOI":"10.1001\/jama.2019.7437","volume":"321","author":"CR Jack","year":"2019","unstructured":"Jack CR, Wiste HJ, Therneau TM, Weigand SD, Knopman DS, Mielke MM et al (2019) Associations of amyloid, tau, and neurodegeneration biomarker profiles with rates of memory decline among individuals without dementia. JAMA 321:2316\u20132325. https:\/\/doi.org\/10.1001\/jama.2019.7437","journal-title":"JAMA"},{"key":"3010_CR16","doi-asserted-by":"publisher","first-page":"2983","DOI":"10.1093\/brain\/aww224","volume":"139","author":"BD James","year":"2016","unstructured":"James BD, Wilson RS, Boyle PA, Trojanowski JQ, Bennett DA, Schneider JA (2016) TDP-43 stage, mixed pathologies, and clinical Alzheimer\u2019s-type dementia. Brain 139:2983\u20132993. https:\/\/doi.org\/10.1093\/brain\/aww224","journal-title":"Brain"},{"key":"3010_CR17","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1212\/CON.0000000000000697","volume":"25","author":"GA Jicha","year":"2019","unstructured":"Jicha GA, Nelson PT (2019) Hippocampal sclerosis, argyrophilic grain disease, and primary age-related tauopathy. Continuum (Minneap Minn) 25:208\u2013233. https:\/\/doi.org\/10.1212\/CON.0000000000000697","journal-title":"Continuum (Minneap Minn)"},{"key":"3010_CR18","doi-asserted-by":"publisher","first-page":"7686","DOI":"10.1002\/alz.14236","volume":"20","author":"Y Kim","year":"2024","unstructured":"Kim Y, Stern Y, Seo SW, Na DL, Jang JW, Jang H et al (2024) Factors associated with cognitive reserve according to education level. Alzheimers Dement 20:7686\u20137697. https:\/\/doi.org\/10.1002\/alz.14236","journal-title":"Alzheimers Dement"},{"key":"3010_CR19","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1038\/hr.2009.100","volume":"32","author":"K Kitagawa","year":"2009","unstructured":"Kitagawa K, Oku N, Kimura Y, Yagita Y, Sakaguchi M, Hatazawa J et al (2009) Relationship between cerebral blood flow and later cognitive decline in hypertensive patients with cerebral small vessel disease. Hypertens Res 32:816\u2013820. https:\/\/doi.org\/10.1038\/hr.2009.100","journal-title":"Hypertens Res"},{"key":"3010_CR20","doi-asserted-by":"publisher","DOI":"10.1186\/s40478-019-0743-1","volume":"7","author":"CS Latimer","year":"2019","unstructured":"Latimer CS, Burke BT, Liachko NF, Currey HN, Kilgore MD, Gibbons LE et al (2019) Resistance and resilience to Alzheimer\u2019s disease pathology are associated with reduced cortical pTau and absence of limbic-predominant age-related TDP-43 encephalopathy in a community-based cohort. Acta Neuropathol Commun 7:91. https:\/\/doi.org\/10.1186\/s40478-019-0743-1","journal-title":"Acta Neuropathol Commun"},{"key":"3010_CR21","doi-asserted-by":"publisher","first-page":"878","DOI":"10.1212\/01.wnl.0000277657.95487.1c","volume":"69","author":"G Li","year":"2007","unstructured":"Li G, Larson EB, Sonnen JA, Shofer JB, Petrie EC, Schantz A et al (2007) Statin therapy is associated with reduced neuropathologic changes of Alzheimer disease. Neurology 69:878\u2013885. https:\/\/doi.org\/10.1212\/01.wnl.0000277657.95487.1c","journal-title":"Neurology"},{"key":"3010_CR22","doi-asserted-by":"publisher","DOI":"10.1002\/dad2.70016","volume":"16","author":"Y Loika","year":"2024","unstructured":"Loika Y, Webster S, Loiko E, Kulminski AM (2024) Resistance and resilience to tau pathology in Alzheimer\u2019s disease: effects of age, sex, and. Alzheimers Dement (Amst) 16:e70016. https:\/\/doi.org\/10.1002\/dad2.70016","journal-title":"Alzheimers Dement (Amst)"},{"key":"3010_CR23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2020.100654","volume":"12","author":"J Maccora","year":"2020","unstructured":"Maccora J, Peters R, Anstey KJ (2020) What does (low) education mean in terms of dementia risk? A systematic review and meta-analysis highlighting inconsistency in measuring and operationalising education. SSM Popul Health 12:100654. https:\/\/doi.org\/10.1016\/j.ssmph.2020.100654","journal-title":"SSM Popul Health"},{"key":"3010_CR24","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1001\/archneur.58.3.517-a","volume":"58","author":"IR Mackenzie","year":"2001","unstructured":"Mackenzie IR, Munoz DG (2001) Effect of anti-inflammatory medications on neuropathological findings in Alzheimer disease. Arch Neurol 58:517\u2013519. https:\/\/doi.org\/10.1001\/archneur.58.3.517-a","journal-title":"Arch Neurol"},{"key":"3010_CR25","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-024-02716-y","volume":"147","author":"C Maldonado-D\u00edaz","year":"2024","unstructured":"Maldonado-D\u00edaz C, Hiya S, Yokoda RT, Farrell K, Marx GA, Kauffman J et al (2024) Disentangling and quantifying the relative cognitive impact of concurrent mixed neurodegenerative pathologies. Acta Neuropathol 147:58. https:\/\/doi.org\/10.1007\/s00401-024-02716-y","journal-title":"Acta Neuropathol"},{"key":"3010_CR26","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1212\/WNL.0000000000004058","volume":"89","author":"IG McKeith","year":"2017","unstructured":"McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D et al (2017) Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB Consortium. Neurology 89:88\u2013100. https:\/\/doi.org\/10.1212\/WNL.0000000000004058","journal-title":"Neurology"},{"key":"3010_CR27","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1017\/S1355617719000122","volume":"25","author":"ZA Melikyan","year":"2019","unstructured":"Melikyan ZA, Corrada MM, Dick MB, Whittle C, Paganini-Hill A, Kawas CH (2019) Neuropsychological test norms in cognitively intact oldest-old. J Int Neuropsychol Soc 25:530\u2013545. https:\/\/doi.org\/10.1017\/S1355617719000122","journal-title":"J Int Neuropsychol Soc"},{"key":"3010_CR28","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0000000000000260","author":"ZA Melikyan","year":"2018","unstructured":"Melikyan ZA, Greenia DE, Corrada MM, Hester MM, Kawas CH, Grill JD (2018) Recruiting the oldest-old for clinical research. Alzheimer Dis Assoc Disord. https:\/\/doi.org\/10.1097\/WAD.0000000000000260","journal-title":"Alzheimer Dis Assoc Disord"},{"key":"3010_CR29","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1212\/wnl.41.4.479","volume":"41","author":"SS Mirra","year":"1991","unstructured":"Mirra SS, Heyman A, McKeel D, Sumi SM, Crain BJ, Brownlee LM et al (1991) The Consortium to Establish a Registry for Alzheimer\u2019s Disease (CERAD). Part II. Standardization of the neuropathologic assessment of Alzheimer\u2019s disease. Neurology 41:479\u2013486. https:\/\/doi.org\/10.1212\/wnl.41.4.479","journal-title":"Neurology"},{"key":"3010_CR30","doi-asserted-by":"publisher","first-page":"e1067","DOI":"10.1212\/WNL.0000000000200832","volume":"99","author":"TJ Montine","year":"2022","unstructured":"Montine TJ, Corrada MM, Kawas C, Bukhari SA, White LR, Tian L et al (2022) Association of cognition and dementia with neuropathologic changes of Alzheimer disease and other conditions in the oldest old. Neurology 99:e1067\u2013e1078. https:\/\/doi.org\/10.1212\/WNL.0000000000200832","journal-title":"Neurology"},{"key":"3010_CR31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00401-011-0910-3","volume":"123","author":"TJ Montine","year":"2012","unstructured":"Montine TJ, Phelps CH, Beach TG, Bigio EH, Cairns NJ, Dickson DW et al (2012) National Institute on Aging-Alzheimer\u2019s Association guidelines for the neuropathologic assessment of Alzheimer\u2019s disease: a practical approach. Acta Neuropathol 123:1\u201311. https:\/\/doi.org\/10.1007\/s00401-011-0910-3","journal-title":"Acta Neuropathol"},{"key":"3010_CR32","doi-asserted-by":"publisher","first-page":"1503","DOI":"10.1093\/brain\/awz099","volume":"142","author":"PT Nelson","year":"2019","unstructured":"Nelson PT, Dickson DW, Trojanowski JQ, Jack CR, Boyle PA, Arfanakis K et al (2019) Limbic-predominant age-related TDP-43 encephalopathy (LATE): consensus working group report. Brain 142:1503\u20131527. https:\/\/doi.org\/10.1093\/brain\/awz099","journal-title":"Brain"},{"key":"3010_CR33","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12981","author":"RS Neuville","year":"2023","unstructured":"Neuville RS, Biswas R, Ho CC, Bukhari S, Sajjadi SA, Paganini-Hill A et al (2023) Study of neuropathological changes and dementia in 100 centenarians in The 90+ Study. Alzheimers Dement. https:\/\/doi.org\/10.1002\/alz.12981","journal-title":"Alzheimers Dement"},{"key":"3010_CR34","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1016\/0021-9681(86)90153-0","volume":"39","author":"A Paganini-Hill","year":"1986","unstructured":"Paganini-Hill A, Ross RK, Henderson BE (1986) Prevalence of chronic disease and health practices in a retirement community. J Chronic Dis 39:699\u2013707","journal-title":"J Chronic Dis"},{"key":"3010_CR35","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1007\/s00401-018-1872-5","volume":"136","author":"JL Robinson","year":"2018","unstructured":"Robinson JL, Corrada MM, Kovacs GG, Dominique M, Caswell C, Xie SX et al (2018) Non-Alzheimer\u2019s contributions to dementia and cognitive resilience in The 90+ Study. Acta Neuropathol 136:377\u2013388. https:\/\/doi.org\/10.1007\/s00401-018-1872-5","journal-title":"Acta Neuropathol"},{"key":"3010_CR36","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1002\/ana.20493","volume":"57","author":"A Ruitenberg","year":"2005","unstructured":"Ruitenberg A, den Heijer T, Bakker SL, van Swieten JC, Koudstaal PJ, Hofman A et al (2005) Cerebral hypoperfusion and clinical onset of dementia: the Rotterdam Study. Ann Neurol 57:789\u2013794. https:\/\/doi.org\/10.1002\/ana.20493","journal-title":"Ann Neurol"},{"key":"3010_CR37","doi-asserted-by":"publisher","first-page":"2302","DOI":"10.1056\/NEJMoa0806142","volume":"360","author":"GM Savva","year":"2009","unstructured":"Savva GM, Wharton SB, Ince PG, Forster G, Matthews FE, Brayne C et al (2009) Age, neuropathology, and dementia. N Engl J Med 360:2302\u20132309. https:\/\/doi.org\/10.1056\/NEJMoa0806142","journal-title":"N Engl J Med"},{"key":"3010_CR38","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1093\/jnen\/nlw026","volume":"75","author":"A Serrano-Pozo","year":"2016","unstructured":"Serrano-Pozo A, Qian J, Muzikansky A, Monsell SE, Montine TJ, Frosch MP et al (2016) Thal amyloid stages do not significantly impact the correlation between neuropathological change and cognition in the Alzheimer disease continuum. J Neuropathol Exp Neurol 75:516\u2013526. https:\/\/doi.org\/10.1093\/jnen\/nlw026","journal-title":"J Neuropathol Exp Neurol"},{"key":"3010_CR39","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12072463","author":"MK Sin","year":"2023","unstructured":"Sin MK, Cheng Y, Roseman JM, Latimer C, Ahmed A, Zamrini E (2023) Characteristics and predictors of Alzheimer\u2019s disease resilience phenotype. J Clin Med. https:\/\/doi.org\/10.3390\/jcm12072463","journal-title":"J Clin Med"},{"key":"3010_CR40","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1159\/000078501","volume":"23","author":"CA Szekely","year":"2004","unstructured":"Szekely CA, Thorne JE, Zandi PP, Ek M, Messias E, Breitner JC et al (2004) Nonsteroidal anti-inflammatory drugs for the prevention of Alzheimer\u2019s disease: a systematic review. Neuroepidemiology 23:159\u2013169. https:\/\/doi.org\/10.1159\/000078501","journal-title":"Neuroepidemiology"},{"key":"3010_CR41","doi-asserted-by":"publisher","first-page":"1791","DOI":"10.1212\/wnl.58.12.1791","volume":"58","author":"DR Thal","year":"2002","unstructured":"Thal DR, R\u00fcb U, Orantes M, Braak H (2002) Phases of A beta-deposition in the human brain and its relevance for the development of AD. Neurology 58:1791\u20131800. https:\/\/doi.org\/10.1212\/wnl.58.12.1791","journal-title":"Neurology"},{"key":"3010_CR42","doi-asserted-by":"publisher","first-page":"2272","DOI":"10.1002\/alz.12552","volume":"18","author":"C Vila-Castelar","year":"2022","unstructured":"Vila-Castelar C, Tariot PN, Sink KM, Clayton D, Langbaum JB, Thomas RG et al (2022) Sex differences in cognitive resilience in preclinical autosomal-dominant Alzheimer\u2019s disease carriers and non-carriers: baseline findings from the API ADAD Colombia Trial. Alzheimers Dement 18:2272\u20132282. https:\/\/doi.org\/10.1002\/alz.12552","journal-title":"Alzheimers Dement"},{"key":"3010_CR43","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1002\/ana.410300503","volume":"30","author":"JP Vonsattel","year":"1991","unstructured":"Vonsattel JP, Myers RH, Hedley-Whyte ET, Ropper AH, Bird ED, Richardson EP Jr. (1991) Cerebral amyloid angiopathy without and with cerebral hemorrhages: a comparative histological study. Ann Neurol 30:637\u2013649. https:\/\/doi.org\/10.1002\/ana.410300503","journal-title":"Ann Neurol"},{"key":"3010_CR44","doi-asserted-by":"publisher","DOI":"10.1002\/alz.14369","volume":"21","author":"X Wang","year":"2025","unstructured":"Wang X, Zhu K, Wu W, Zhou D, Lu H, Du J et al (2025) Prevalence of mixed neuropathologies in age-related neurodegenerative diseases: a community-based autopsy study in China. Alzheimers Dement 21:e14369. https:\/\/doi.org\/10.1002\/alz.14369","journal-title":"Alzheimers Dement"},{"key":"3010_CR45","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1212\/WNL.0000000000002480","volume":"86","author":"LR White","year":"2016","unstructured":"White LR, Edland SD, Hemmy LS, Montine KS, Zarow C, Sonnen JA et al (2016) Neuropathologic comorbidity and cognitive impairment in the Nun and Honolulu-Asia aging studies. Neurology 86:1000\u20131008. https:\/\/doi.org\/10.1212\/WNL.0000000000002480","journal-title":"Neurology"}],"container-title":["Acta Neuropathologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00401-026-03010-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00401-026-03010-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00401-026-03010-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T16:16:24Z","timestamp":1775492184000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00401-026-03010-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,6]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["3010"],"URL":"https:\/\/doi.org\/10.1007\/s00401-026-03010-9","relation":{},"ISSN":["1432-0533"],"issn-type":[{"value":"1432-0533","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,6]]},"assertion":[{"value":"19 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 March 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 April 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the Institutional Review Board of the University of California Irvine and performed in accordance with ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All participants or their designated surrogates provided written informed consent to participate in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}],"article-number":"36"}}