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NAD+ levels tend to decrease with aging and under conditions of nutrient disturbance, contributing to these disorders

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for example, donepezil has been reported to interact with both P -gp and BCRP, underscoring how BBB efflux biology may influence brain drug availability and therapeutic response ( In AD, BBB integrity is often altered due to vascular dysfunction, inflammation, and cerebral amyloid angiopathy (Sweeney et al., 2018