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Detailed clinicopathologic correlations using twin longitudinal data and post\u2010mortem examinations are mostly missing. We describe clinical and pathologic findings of seven monozygotic (<jats:styled-content style=\"fixed-case\">MZ<\/jats:styled-content>) and dizygotic (<jats:styled-content style=\"fixed-case\">DZ<\/jats:styled-content>) twin pairs. Our findings show good agreement between clinical and pathologic diagnoses in the majority of the twin pairs, with greater neuropathologic concordance in <jats:styled-content style=\"fixed-case\">MZ<\/jats:styled-content> than <jats:styled-content style=\"fixed-case\">DZ<\/jats:styled-content> twins. Greater neuropathologic concordance was found for <jats:styled-content style=\"fixed-case\">\u03b2<\/jats:styled-content>\u2010amyloid than tau pathology within the pairs. <jats:styled-content style=\"fixed-case\">ApoE<\/jats:styled-content>4 was associated with higher <jats:styled-content style=\"fixed-case\">\u03b2<\/jats:styled-content>\u2010amyloid and earlier dementia onset, and importantly, higher frequency of other co\u2010occurring brain pathologies, regardless of the zygosity. Dementia onset, dementia duration, difference between twins in age at dementia onset and at death, did not correlate with <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> pathology. These clinicopathologic correlations of older identical and fraternal twins support the relevance of genetic factors in <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>, but not their sufficiency to determine the pathology, and consequently the disease, even in monozygotic twins. It is the interaction among genetic and non\u2010genetic risks which plays a major role in influencing, or probably determining, the degeneration of those brain circuits associated with pathology and cognitive deficits in <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/bpa.12127","type":"journal-article","created":{"date-parts":[[2014,1,23]],"date-time":"2014-01-23T11:46:57Z","timestamp":1390477617000},"page":"317-333","source":"Crossref","is-referenced-by-count":12,"title":["Neuropathologic Assessment of Dementia Markers in Identical and Fraternal Twins"],"prefix":"10.1111","volume":"24","author":[{"given":"Diego","family":"Iacono","sequence":"first","affiliation":[{"name":"The Brain Bank at Karolinska Institutet KI Alzheimer Disease Research Center Department of Neurobiology Care Sciences and Society (NVS) Karolinska Institutet  Stockholm Sweden"},{"name":"Neuropathology Research Biomedical Research Institute of New Jersey, BRInj  Cedar 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