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. 2023 Dec 1;9:432. doi: 10.1038/s41420-023-01732-3

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© The Author(s) 2023

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — As such, a range of genetic, epigenetic and environmental factors (identified as RF1 to RF6 in the schematic) may promote neurodegenerative processes that ultimately cause cognitive impairment. Alterations of mitochondria have been detected in brains of AD patients. These mitochondrial changes may depend on various upstream and/or modifying processes (depicted as risk factor 1 and 2), which could cumulatively compromise mitochondrial function. While severe mitochondrial lesions may be sufficient to trigger a neurodegenerative cascade, it is also possible that additional factors (indicated here as risk factor 3 and 4) are required to irreversibly undermine neuronal survival. Created with Biorender.com.