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Lactic and pyruvic acid accumulation in T21 often stems from compromised activity of mitochondrial complexes I and IV, leading to a metabolic bottleneck that forces reliance on anaerobic glycolysis for energy 55,56

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For certain analyses, participants from the HC and SCD groups were combined into a single group of cognitively normal (CN), while those with MCI and dementia were grouped together into a cognitively impaired (CI) group