White matter loss in an area of the brain known as the fornix may be associated with cognitive decline in healthy elderly patients and may be helpful in predicting the earliest clinical deterioration, according to a study by Evan Fletcher, Ph.D., of the University of California, Davis, and cagues.  The study was published on line, September 9, 2013 in JAMA Neurology.

Atrophy in the hippocampus is well recognized in the later stages of cognitive decline and is one of the most studied changes associated with the Alzheimer disease process. However, changes to the fornix and other regions of the brain structurally connected to the hippocampus are still being described, according to the study background.

The study included 102 cognitively normal elderly patients, with an average age of 73 years, recruited through community outreach, and the study used magnetic resonance imaging and other scanning scans during repeated visits over four years.

According to the results, changes in fornix white matter volume were "highly significant predictors" of cognitive decline.

"This could be among the first studies establishing fornix degeneration as a predictor of incipient cognitive decline among healthy elderly individuals," the study concludes.