What primary pathological change is associated with Alzheimer's disease?

Rationale: A. The hallmark pathological features of Alzheimer’s disease are extracellular amyloid-beta plaques and intracellular neurofibrillary tangles composed of hyperphosphorylated tau protein. These protein accumulations disrupt neuronal communication, impair synaptic function, and lead to progressive neuronal death, which underlies the cognitive decline characteristic of Alzheimer’s disease. B. This mechanism is more characteristic of vascular dementia, where cerebrovascular disease reduces blood flow and causes ischemic injury to brain tissue, leading to cognitive decline. C. While neuroinflammation may contribute to the progression of Alzheimer’s disease, it is not the primary pathological change. It is a secondary process that exacerbates neuronal damage but does not define the disease. D. Alpha-synuclein accumulation forms Lewy bodies, which are the hallmark of Lewy body dementia and Parkinson’s disease dementia, not Alzheimer’s disease.