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David H. Salat, BA; Jeffrey A. Kaye, MD; Jeri S. Janowsky, PhD

Arch Neurol. 1999;56:338-344.

Objectives  To quantify the contribution of gray and white matter volumes to total prefrontal volume in healthy aging. To determine if prefrontal tissue volumes distinguish healthy aging from Alzheimer disease (AD).

Design  Volumes of total prefrontal cortex, prefrontal gray matter, and prefrontal white matter were compared among young healthy elderly (YHE) (n=14; mean age, 70 years), old healthy elderly (OHE) (n=14; mean age, 90 years), and subjects with AD (n=14; mean age, 70 years) by analysis of variance. Additionally, Pearson correlations were performed between volumes and age.

Results  Old healthy elderly and subjects with AD had significantly less total prefrontal volume (approximately 15% less in both groups) and prefrontal white matter volume (approximately 30% less and 20% less in the OHE and AD groups, respectively) than YHE, but there were no differences between the OHE and AD groups. There was a significant difference in gray-white matter volume ratio with OHE having a higher ratio than YHE. Subjects with AD did not differ from YHE or OHE in this ratio. There were significant negative correlations between age and total prefrontal volume and age and prefrontal white matter volume in the healthy subjects.

Conclusions  In the very old, the decline of white matter volume is disproportionately greater than the decline of gray matter volume. In subjects with AD both gray and white matter loss contribute to the decline of prefrontal volume. This is demonstrated by the gray-white matter ratio that does not differ between YHE and subjects with AD. Thus, it is likely that AD is different from accelerated aging.

From the Departments of Behavioral Neuroscience (Mr Salat and Dr Janowsky) and Neurology (Drs Kaye and Janowsky), Oregon Health Sciences University, Portland.

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