Cited by 306Alzheimer's disease research and treatmentsDementia and Cognitive Impairment ResearchMitochondrial Function and Pathology

The DOI matches its Crossref record; 152 of the 157 references it cites were found in a registry or an index; none of the 220 sources its claims cite is checked for support yet.

Brain aging, Alzheimer's disease, and mitochondria

Open access
Swerdlow, Russell H.·2011·Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease

Abstract

The relationship between brain aging and Alzheimer’s disease (AD) is contentious. One view holds AD results when brain aging surpasses a threshold. The other view postulates AD is not a consequence of brain aging. This review discusses this conundrum from the perspective of different investigative lines that have tried to address it, as well as from the perspective of the mitochondrion, an organelle that appears to play a role in both AD and brain aging. Specific issues addressed include the question of whether AD and brain aging should be conceptually lumped or split, the extent to which AD and brain aging potentially share common molecular mechanisms, whether beta amyloid should be primarily considered a marker of AD or simply brain aging, and the definition of AD itself.

Overview

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TL;DR

This review argues that Alzheimer’s disease (AD) and brain aging may be mechanistically linked, with mitochondrial dysfunction as a possible upstream driver of late-onset AD and beta amyloid (Aβ) as a downstream marker. It contrasts this mitochondrial cascade hypothesis with the amyloid cascade hypothesis and notes that new AD criteria classify many elderly individuals with Aβ changes as having preclinical or prodromal AD.

Key findings

  • AD is strongly age-associated: it affects 5.4 million Americans and is estimated to cost $385 billion per year; about 1 in 8 people over 65 is estimated to have AD, 40–50% past age 85 may have it, and some very elderly subgroups surpass 50%.
  • Aβ pathology is common in non-demented elderly: Pittsburgh Compound B PET studies report roughly 20–40% of non-demented elderly are PIB-positive, rising with age, and 65% of those past 80 show PIB retention; plaques and tangles also occur in non-demented individuals.
  • Mitochondrial changes occur in both brain aging and AD: aging shows reduced complex I and complex IV activity with preserved complex II, a 5-kilobase mtDNA deletion increases with age, and mtDNA mutates at approximately 10 times the rate of nuclear DNA; AD shows reduced COX activity in brain, platelets, and fibroblasts, including MCI platelets and young adult APOE4 carriers.
  • The mitochondrial cascade hypothesis proposes that age-related mitochondrial decline promotes brain aging features including Aβ accumulation; when mitochondrial decline surpasses a threshold, compensatory mechanisms fail and late-onset AD ensues, making Aβ a downstream marker rather than an upstream cause.

Methods

  • Narrative review; no primary data, systematic search, or meta-analysis is described.
  • Synthesizes clinical, neuropathological, neuroimaging, biomarker, and mitochondrial/biochemical literature to compare AD and brain aging.
  • Discusses evidence from prior cohorts and models, including PIB PET studies, cybrid cell lines, COX activity measurements, and APP-processing experiments.

Limitations

  • Stated: descriptive and observational studies cannot assign causality, and mechanistic inferences from descriptive observation are described as frequently inaccurate or misleading; biomarker correlation or chronology does not show that one biomarker change drives another.
  • Stated: the mitochondrial cascade hypothesis is a hypothesis and does not address whether Aβ functions as a toxic intermediate in late-onset, non-autosomal dominant AD; it also implies early-onset autosomal dominant and late-onset AD may not share a common etiology.
  • Evident from the text: as a narrative review, it provides no new experimental data and relies on selected cited literature and speculative synthesis rather than a systematic assessment.

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Integrity signals

Registry

Crossref · 10.1016/j.bbadis.2011.08.012

Cites

152 of 152 references verified0 citation errors · 0 not checkable

Statistics

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Verification

Claims the paper makes

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Show all 60 claims

  • It may state two separate claims as one. 36
  • Probably not a substantial claim. 14
45 of 45
  • The authors state this as an assumption.

    Brain aging and Alzheimer’s disease are mechanistically related.

    “Rather than assuming brain aging and AD are mechanistically divergent phenomena, the mitochondrial cascade hypothesis assumes brain aging and AD are mechanistically related.”
1 of 1

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Citations

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5 of the 157 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. White, 2011, Dissonance in diagnoses of dementia type during life with attribution determined at autopsy in the Honolulu-Asia Aging Study; impact of high prevalence of mixed pathology and specificity/non-specificity of clinical manifestations in the very old, Neurology, PL01.002
  2. Rentz, 2006, Amyloid imaging with Pittsburgh Compound-B (PIB) in AD, MCI, and highly intelligent older adults, Neurology, 66, A66

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Metadata

Authors
Swerdlow, R. H.
Affiliations
University of Kansas (US)
Corresponding author
Swerdlow, Russell H.
Venue
Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease
Publisher
Elsevier BV
Published
2011-12
Volume
1812
Issue
12
Pages
1630-1639
ISSN
0925-4439 (ISSN-L)
OpenAlex
W2107600848
Cited by
306
References
157
Citations by year
2026: 3 · 2025: 10 · 2024: 17 · 2023: 14 · 2022: 23 · 2021: 27 · 2020: 27 · 2019: 28 · 2018: 26 · 2017: 17 · 2016: 24 · 2015: 17 · 2014: 20 · 2013: 29 · 2012: 22
FWCI
2.50
Type
journal article
Language
en
Open access
Locations
  • Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • P30AG035982
  • Morgan Family Foundation
Topics
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Mitochondrial Function and Pathology
Keywords
Alzheimer's disease, brain aging, mitochondria, amyloid-beta, bioenergetic stress, mitochondrial dysfunction, disease definition, molecular mechanisms, threshold hypothesis
MeSH terms
Aging, Alzheimer Disease, Brain, Humans, Mitochondria, Amyloid beta-Peptides

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