Preserved cognition in elderly with intact rhinal cortex

Alzheimers disease pathology leads to neurodegeneration within the memory-related structures of the medial temporal cortex and hippocampus. Neurodegeneration also occurs as a part of normative aging and it is unclear whether medial temporal lobe subregions are selectively intact in older adults with preserved cognitive function in comparison to adults who are cognitively impaired. In this study, we used T1-weighted and high-resolution T2-weighted magnetic resonance images to assess age-related volumetric changes to medial temporal lobe regions, including the hippocampal formation and rhinal cortex, in patients with mild cognitive impairment and cognitively normal controls in two independent cohorts. Our results show age was significantly associated with regional atrophy in the hippocampus, but not the rhinal cortex. Additionally, variability in regional medial temporal lobe volume was associated with tau uptake in the rhinal cortex, but not the hippocampus. Together, these results suggest that the rhinal cortex may be more indicative of Alzheimers disease pathology and can help differentiate from age-related neurodegeneration.