Aim: The current study sought to determine which types of cognitive function are related to atrophy of the bilateral medial temporal areas including the entorhinal cortex (MTA-ERC) in elderly adults. Methods: The subjects were 96 elderly adults (mean age 75.3 years) with mild cognitive impairment. Subjects underwent Wechsler Memory Scale-Revised, logical memory I and II (WMS-R, LM I and II), Rey complex figure retention tests after 3 and 30 min (RCF-3 min and RCF-30 min), digit span backword (DSB), digit symbol-coding (DSC), Stroop Color and Word Test-Interference List (SCWT-IL) as well as magnetic resonance imaging (MRI) and were divided into elderly adults without or with mild to moderate MTA-ERC atrophy, and those with severe atrophy. Results: In all subjects, MTA-ERC atrophy showed significant relationships with age (r = 0.43), education (r = –0.25), WMS-R, LM I (r = –0.21), DSC (r = –0.32), and SCWT-IL (r = 0.32). The mild to moderate atrophy group showed significant relationships between MTA-ERC atrophy and age (r = 0.34), DSC (r = –0.28), and SCWT-IL (r = 0.25). In contrast, in the severe atrophy group, MTA-ERC atrophy was correlated significantly with RCF-3 min (r = –0.70) and RCF-30 min (r = –0.74). The linear regression model included demographic variables and cognitive tests; two variables to survive the step-wise analysis were age (β = 0.374) and SCWT-IL (β = 0.247) in all subjects. Age (β = 0.301), and RCF-30 min (β = –0.521) and age (β = 0.460) remained as a significant variable in the mild to moderate atrophy and severe atrophy groups, respectively. Conclusion: Executive function tests such as SCWT-IL may be useful as a screening tool to identify mild to moderate MTA-ERC atrophy and a decline in the RCF test may suggest severe MTA-ERC atrophy in elderly adults with MCI.

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