Cognitive decline associated with Alzheimer's disease is primarily driven by tau accumulation in the brain, which necessitates the presence of amyloid. While many individuals can have amyloid without suffering cognitive issues, it is the interaction between amyloid and tau that accelerates tau deposition. Over time, amyloid seems to encourage abnormal tau to accumulate, leading to widespread cognitive impairment. Thus, the dynamics of Alzheimer's disease hinge on the relationship between amyloid and tau, with both playing crucial roles in the progression of the disease.

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