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Behavioural Neurology
Volume 21 (2009), Issue 1-2, Pages 29-37

Cognitive Phenotypes, Brain Morphometry and the Detection of Cognitive Decline in Preclinical AD

Mark W. Jacobson,1,2 Linda K. McEvoy,4 Anders Dale,3,4 and Christine Fennema-Notestine2,4

1Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
2Department of Psychiatry, University of California San Diego, San Diego, CA, USA
3Department of Neurosciences, University of California San Diego, San Diego, CA, USA
4Department of Radiology, University of California San Diego, San Diego, CA, USA

Received 16 October 2009; Accepted 16 October 2009

Copyright © 2009 Hindawi Publishing Corporation and the authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Identifying a preclinical phase of Alzheimer’s Disease (PCAD) that is distinct from cognitive changes in healthy aging continues to be a major research focus. Combining neuropsychological and neuroimaging methodologies should improve our ability to differentiate healthy from pathological aging, although studies that utilize both methods often result in equivocal findings, possibly due to variability in cognitive test performance that may be capturing distinct phenotypes. One method of capturing this cognitive variability is to utilize contrasting neuropsychological tests to identify subgroups representative of distinct cognitive phenotypes, and determine whether differences in brain morphometry support these classifications. We review several approaches to defining cognitive subgroups, and we consider the possibility that cognitive asymmetry might provide one means of identifying both functional and structural changes associated with aging and dementia.