SANTA FE, N.M. (AP) — The main cause of Gene Hackman’s death was heart disease, but he was also in the advanced stages of Alzheimer’s disease and likely had not eaten for a long time, according to a new autopsy report.

Gene Hackman died from heart disease and advanced Alzheimer's, an autopsy confirms. His wife, Betsy Arakawa, likely died days earlier from hantavirus. Investigations continue into the couple's tragic deaths.

Given the actor’s “advanced state” of Alzheimer’s disease, “it’s quite possible” that Hackman didn’t realize his wife had died in the days before his own death, says the New Mexico chief medical examiner.