The present study sought to determine if volumes of specific brain structures could discriminate cognitively normal seniors destined to develop mild cognitive impairment (MCI) within a few years from those who will remain normal. Brain scans were collected from seventy-one cognitively normal seniors. Seventeen individuals later developed MCI (the presymptomatic MCI; pMCI group), while fifty-four remained normal. Whole brain volume (WBV) and volumes of the entorhinal cortex (ERC), hippocampus, and three subregions of the hippocampus (head; HH, body; HB and tail; HT) were compared. Results indicated that the pMCI group had smaller volumes than the normal group in the ERC, HH and HB, but not the HT or WBV. When HH/HB volumes and baseline memory test scores were included in a single logistic regression model, classification accuracy was very high (area under the curve=0.93). These results show that smaller normalized volumes of anterior medial temporal lobe structures contribute to the development of MCI, a finding which may have implications for identifying seniors at risk for cognitive decline.

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