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AD should be considered a disorder of consciousness and should motivate further investigation into the dimensions of awareness affected by the disorder with implications for treatment and management of people with dementia.
Evidence is provided that pharmacological and pathological loss of responsiveness involve distinct neurotransmitter system contributions across individual basal ganglia nuclei, offering a novel framework for targeted therapeutic interventions in patients with disorders of consciousness.
The cross-sectionally analysed associations suggest that insulin sensitivity warrants investigation as a modifiable midlife factor for cognitive health; interventional studies are needed to determine whether targeting it preserves cognition before neurodegenerative markers emerge.
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