Sarcopenia, the age-related loss of muscle mass, strength, and performance, is a significant concern in the aging population. Despite extensive research, no consensus exists on its prevention and treatment. Sarcopenia increases the risk of functional disability, falls, hospitalization, long-term care, morbidity, and mortality among older adults.Currently, no approved pharmacological treatments for sarcopenia exist, making exercise and nutrition the most effective interventions. Evidence indicates that targeted exercise reduces risk factors, preventing or treating sarcopenia in older adults. Progressive, moderate-intensity exercise, alone or combined with nutritional supplementation, is recommended to mitigate muscle deterioration associated with aging. While non-pharmacological interventions are the primary approach, conflicting evidence exists regarding the most effective exercise and nutrition strategies. This review highlights that single intervention, such as exercise or nutritional supplementation alone, provide limited benefits for preventing or treating sarcopenia. In contrast, combined interventions, comprehensive exercise training and nutritional supplementation, effectively improve clinical indicators, including muscle mass, strength, and gait speed, in older adults with sarcopenia.

BACKGROUND:Alzheimer's disease, marked by amyloid-β accumulation, is a leading cause of dementia. Gut microbiota may influence its development by affecting inflammation or amyloid-β metabolism. However, this association is not well studied in older adults in Japan, whose characteristic diet may uniquely impact gut bacteria. OBJECTIVE:To determine the association between the gut microbiota and positron emission tomography (PET)-determined brain amyloid-β positivity in community-dwelling older adults in Japan. METHODS:This cross-sectional study investigated 136 participants aged 68-86 years from Tokyo. Brain amyloid-β was assessed using PET imaging, and gut microbiota were analyzed from fecal samples using 16S rRNA gene sequencing processed with the QIIME2 pipeline. Taxonomic composition was evaluated at both the phylum and genus levels; participants were classified into above- and below-median groups based on the relative abundance of each taxon. Binomial logistic regression adjusted for age, sex, and antibiotic use was conducted to examine the association between bacterial abundance and PET positivity. For genus-level analyses, p-values were further corrected for multiple comparisons. In addition, α diversity (Shannon, Simpson, Observed OTUs) and β diversity (PCoA based on unweighted UniFrac distances, PERMANOVA) were compared between PET-positive and PET-negative groups. RESULTS:Of the 136 participants, 34.6% were PET-positive for amyloid-β. Firmicutes showed a significant difference: 26.4% PET-positive in the above-median group vs. 42.6% in the below-median group (p for χ² = 0.047). The binomial logistic regression analysis showed that lower Firmicutes abundance was significantly associated with an increased odds of PET positivity (odds ratio and confidence interval: 2.15 [1.03, 4.52]). At the genus level, no taxon remained significant after correction for multiple comparisons. No significant differences were observed in α or β diversity indices between groups. CONCLUSION:A lower abundance of Firmicutes may be associated with amyloid-β accumulation in the brain, linking the gut microbiota to Alzheimer's disease.

While many studies have described the association between cognitive decline and eating habits, little attention has been paid to its association with cheese intake. In this epidemiological study of 1035 community-dwelling women aged ≥ 65, we investigated the association between intake/type of cheese and cognitive function. The anthropometry, functional ability, and the frequency of food intake, including cheese, were assessed. The mini-mental state examination (MMSE) was used to assess cognitive function, and a score of 20–26 was operationally defined as mild cognitive decline. We found that the MMSE score was significantly different between the presence of cheese intake and not (cheese intake: 28.4 ± 1.9; non-cheese intake: 27.6 ± 2.4) and between those who consumed Camembert cheese and those who did not (Camembert cheese: 28.7 ± 1.4; others: 28.3 ± 2.0). After adjusting for confounders, multiple logistic regression identified four independent variables significantly associated with mild cognitive decline: Camembert cheese intake (odds ratio = 0.448, 95% confidence interval = 0.214–0.936), age, usual walking speed, and repetitive saliva swallowing test scores. Our results, while based on cross-sectional data from Japanese community-dwelling older women, identified the significant inverse association between Camembert cheese intake and mild cognitive decline.

Social isolation among older adults affects their physical and mental health. Ego-resilience is associated with flexible adaptation to various environments and acceptable behaviors. However, its association with social isolation among older people is unclear. Therefore, a health survey was conducted with 510 adults aged 65 years or older to assess social isolation, its associated factors, and ego resilience. The results showed that the social isolation group had a lower median ego-resiliency scale score (42.0) compared to the non-social isolation group (38.0). The social isolation group were mostly males without spouses, took time to move, had more depressive moods, and poorer subjective health status. The non-social isolated group had faster maximum walking speed. Low ego-resilience was newly identified as a factor associated with social isolation among older people, as were being male, having no spouse, and depressive symptoms. Mediation analysis revealed that ego-resilience affected social isolation and was partially mediated by depressive symptoms.

This study was aimed to evaluate the hierarchical accumulation of amyloid in the Alzheimer’s brain according to clinical stage using [ 18 F]flutemetamol positron emission tomography. This was a prospective, single-cohort study of volunteers who lived independently in Itabashi-ku (Tokyo, Japan). One hundred thirty-six participants (female/male = 96/40, mean age/standard deviation = 79.2/4.0 years) were recruited. Two subjects, one with meningeal thickening and another with sequelae in the brain, and 17 visually amyloid-negative MCI subjects who possibly had neurodegenerative disease other than Alzheimer’s disease were excluded from the further analysis. We applied voxel-based regression slope analysis using composite voxel of interest values calculated with Cortex ID Suite (GE Healthcare) and [ 18 F]flutemetamol positron emission tomography images in three groups: 70 amyloid-negative cognitively normal (CN) participants, 29 amyloid-positive cognitively normal (PreC) participants, and 18 amyloid-positive MCI (MCI+) participants. Statistical Parametric Mapping 12 software was used for analysis. Compared with the CN group, the PreC group showed accelerated amyloid accumulation in a wide area, except for the medial temporal lobe, paracentral sulcus, and medial occipital lobe. In amyloid-positive subjects, amyloid accumulation was quicker in the paracentral sulcus, occipital cortex, and left medial temporal lobe in the MCI+ group than in the PreC group. Additional voxel of interest analyses were applied to the statistically significant areas. In the right posterior cingulate area, there was no significant difference between the PreC and MCI+ groups; however, the PreC and MCI+ groups showed a significantly quicker amyloid accumulation than the CN group. In contrast, in the left medial temporal area, the increase of amyloid accumulation was greater only in the MCI+ group compared to the PreC and CN groups. In amyloid-positive subjects, amyloid accumulation in the left medial temporal lobe did not increase in the preclinical stage. In the medial temporal and occipital lobes, which are relatively spared from amyloid accumulation, it is considered to start late in the MCI stage and not in the preclinical stage. Further study of volume and other biomarkers is requreid to evaluate the regional pathophysiological variability of AD.

Objectives　Although the effectiveness of status-to-interview-guided exercise therapy to improve urinary incontinence has been reported, reports on non-face-to-face guided exercise therapy are lacking. This study aimed to analyze the effect of using non-face-to-face training guidance for walking and strength training on the frequency and degree of urinary incontinence and improvement in the urinary incontinence-induced decline in the quality of life (QoL) of community-dwelling middle-aged and older women.Methods　This study included 68 women, aged 46-64 years, having self-evaluated stress urinary incontinence. The participants in the intervention group watched a video that guided them on how to walk effectively and gradually increase their number of steps. Additionally, a non-face-to-face lecture was conducted on the comprehensive training content, including muscle strengthening exercises necessary for walking at home, as muscle weakness is one of the causes of urinary incontinence. The control group was instructed to continue living as usual without any interventions. The intervention period was 12 weeks. The primary endpoints included the urinary leakage frequency score, urinary leakage volume score, and degree of decline in the QoL, and these were compared before and after the intervention using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). To elucidate the effect of the increase in the step count on the primary outcome, we calculated the rate of increase in the step count before and after the intervention in the intervention group. Moreover, a sub-analysis was performed for the high-step count (n=16) and low step-count (n=16) groups before and after the intervention.Results　Significant differences were observed in the urinary leakage frequency, urinary leakage volume, and ICIQ-SF scores at 12 weeks post-intervention between the groups (P<0.05). In the high-step count group, both the urinary leakage frequency and ICIQ-SF scores showed a significant tendency to improve from 8 weeks compared to the pre-intervention scores.Conclusion　Since this study was conducted as an open-label trial, the possibility of an inherent bias in subjective outcome assessment should be considered during interpretation of the results. Our findings indicate that walking and muscle strength training, even with non-face-to-face guidance, for middle-aged and older community-dwelling women with urinary incontinence can effectively improve the urinary leakage symptoms and degree of decline in the QoL. Furthermore, greater effects could be expected by encouraging an increase in the number of daily steps with the intervention.

IntroductionThis longitudinal study aimed to identify aging trajectory patterns of social interaction by sex and determine the association between these patterns and all-cause mortality.MethodsParticipants were 4,065 community-dwelling older adults (1849 men) in Japan, aged 65–89 years, who responded twice or more to a mail survey conducted between 2012 and 2020. Social interaction was examined through the frequency of face-to-face and non-face-to-face contact with non-resident family and friends. The aging trajectories of the social interaction scores were identified using group-based trajectory modeling.ResultsTwo groups were identified among both men and women. Among men with high-frequency interaction, a rapid decrease in the frequency of social interaction was observed after 80 years of age. Conversely, among women, the frequency tended to remain the same, even after 80 years of age. The social interaction score among those aged 65 years in the low-frequency group was approximately 4 points for men and 6 points for women. Among men, no decrease was observed; however, it tended to decline after 85 years of age among women. Among men, the factors associated with the low-frequency group were instrumental activities of daily living score, perceived financial status, and social participation, while among women, they were self-rated health and social participation. The adjusted hazard ratio in the low-frequency group for all-cause mortality was 1.72 (95% confidence interval, 1.27–1.72) for men and 1.45 (95% confidence interval, 0.98–2.14) for women.DiscussionIn the low-frequency group, men had a higher risk of all-cause mortality than women. Daily social interaction from mid-age is important to reduce the risk of social isolation and all-cause mortality in later life.

Introduction: Since soy isoflavones compensate for age-related estrogen reduction, adequate intake of soy products may prevent the decline in activities of daily living (ADL) due to estrogen reduction in women. However, it is unclear whether regular soy product intake prevents ADL decline. This study examined the effects of soy product consumption on basic/instrumental ADL (BADL/IADL) in Japanese women 75 years or older for 4 years. Materials and Methods: The subject population consisted of 1289 women aged 75 years or older living in Tokyo who underwent private health examinations in 2008. For 1114 (or 1042) participants without baseline BADL (or IADL) disability, we examined the association between baseline soy product consumption frequency and the BADL (or IADL) disabilities 4 years later using logistic regression analyses. The models were adjusted for baseline age, or further for dietary variety for food groups other than soy products, exercise and sport participation, smoking, pre-existing disease number, and body mass index. Results: Regardless of adjustment for potential confounding factors, less frequent soy product consumption was associated with higher BADL or IADL disability incidence. In the fully adjusted models, the trend toward a higher incidence of disabilities with less frequent soy product consumption was statistically significant for both BADL (p = 0.001) and IADL (p = 0.007). Conclusions: Those who consumed soy products more frequently at baseline were less likely to develop BADL and IADL disabilities after 4 years than those who did not. The results show that daily soy product consumption may prevent functional ADL decline in older Japanese women.

This study was aimed to evaluate the regional hierarchical brain atrophy among the preclinical to mild cognitive impairment (MCI) stages of Alzheimer’s disease associated with amyloid deposition using [ 18 F]flutemetamol positron emission tomography and volumetric magnetic resonance imaging. This was a prospective, single-cohort study of volunteers who were living independently in Itabashi-ku (Tokyo, Japan). One hundred thirty-six participants (female/male = 96/40, mean age/standard deviation = 79.2/4.0 years) were recruited. Two subjects, one with meningeal thickening and another with sequelae in the brain, and 17 visually amyloid-negative MCI subjects who possibly had neurodegenerative disease other than Alzheimer’s disease were excluded from the further analysis. We applied voxel-based regression slope analysis between composite voxel of interest values calculated with Cortex ID Suite (GE Healthcare) on [ 18 F]flutemetamol positron emission tomography and volumetric magnetic resonance images in three groups: 70 amyloid-negative cognitively normal (CN) participants, 29 amyloid-positive cognitively normal (PreC) participants, and 18 amyloid-positive MCI (MCI+) participants. Statistical Parametric Mapping 12 software was used for analysis. Even in the cognitively normal stage, the PreC group showed a larger slope of atrophy in the basal forebrain and middle frontal gyri than the CN group. In the MCI+ group, the slopes were larger in the lateral and medial parietal lobes, uncus, and right lateral temporal areas. The speed of amyloid-related atrophy in the basal forebrain and middle frontal gyri was quick even in the preclinical stage of Alzheimer’s disease. As no significant slope changes were observed among the three groups in the medial temporal area, except for the uncus, the well-known medial temporal atrophy in early Alzheimer’s disease might not be related to the accumulation of amyloid.

Diet modification may contribute to the prevention of age-related cognitive decline. The association between dairy product consumption and cognitive function in older people remains unknown. We investigated whether cheese intake is associated with lower cognitive function (LCF) in community-dwelling older adults. This cross-sectional study included 1503 adults aged over 65 years. The analyzed data were obtained through face-to-face interviews and functional ability measurement. Cognitive function was assessed using the mini-mental state examination (MMSE), and a score ≤23 was defined as LCF. The prevalence of LCF was 4.6%, and this group had smaller calf circumference, slower usual walking speed, and a more frequent history of anemia than subjects with MMSE scores >23. After adjusting for confounding factors, logistic regression analysis revealed cheese intake (odds ratio (OR) = 0.404, 95% confidence interval (CI) = 0.198–0.824), age (OR = 1.170, 95% CI = 1.089–1.256), usual walking speed (OR = 0.171, 95% CI = 0.062–0.472) and calf circumference (OR = 0.823, 95% CI = 0.747–0.908) to be significant factors associated with LCF. Although the present study was an analysis of cross-sectional data of Japanese community-dwelling older adults, the results suggest that cheese intake is inversely associated with LCF.

This study aims to identify the trajectory of psychological well-being during the COVID-19 pandemic among community-dwelling older adults and to clarify the association between coping behavior in the early stage of the pandemic and the trajectory of psychological well-being. The study was based on a cohort study, known as "the Otassha Study." We administered three follow-up surveys to 720 older adults who participated in the survey in October 2019 (T0): T1: June 2020, T2: October 2020, and T3: October 2021. Furthermore, we assessed coping behavior in T1 via a self-developed questionnaire comprising 10 items. Psychological well-being was assessed by the WHO-5 Well-Being Index (score range: 0 to 25) in all surveys. The trajectories of psychological well-being were identified by group-based trajectory modeling. The association between coping behaviors and trajectory patterns was assessed using multinomial logistic regression analysis. Furthermore, among the 508 participants who participated in the follow-up survey two times or more, three patterns of the trajectory of psychological well-being were identified: heavily decreased group (n = 39), decreased group (n = 352), and increased group (n = 39). "Walking" as a coping behavior had a significantly higher odds ratio (OR) to be in the increased group (OR = 2.32, 95 % confidence interval (CI) 1.06-5.05, p = 0.035) compared to the heavily decreased group. "Conversations with family living together" had a slightly higher OR to become an increased group (OR = 1.96, 95 % CI: 0.87-4.41, p = 0.106), and "actively gathering information on COVID-19" had a slightly lower OR to become the decreased group (OR = 0.53, 95 % CI: 0.26-1.06, p = 0.072) compared to the heavily decreased group. The results of this study suggest how maintaining health in the early stage of the pandemic had a great influence on the long-term health status.

AimRadio‐Taiso, a traditional exercise program in Japan, may serve as a coping strategy for older adults with frailty during the COVID‐19 pandemic. This phase II trial tested program adherence and safety and explored the potential effectiveness of a home‐based Radio‐Taiso.MethodsThis assessor‐blind parallel randomized controlled trial included community‐dwelling Jolder Japanese adults with frailty and pre‐frailty. Fifty‐eight eligible participants were randomly allocated to intervention and control groups. Intervention participants performed 3–5‐min sessions of Radio‐Taiso one to four times per day for 12 weeks. Feasibility criteria were set at practice and retention rates of ≥75%. Safety was monitored by assessing all adverse events reported by participants during the intervention period, irrespective of causality. Potential effectiveness was exploratorily assessed using items that allow clinical interpretation of changes: mobility and health‐related quality of life (HR‐QoL), assessed using the modified short physical performance battery (SPPB) and the SF‐36, respectively.ResultsBoth practice (83%) and retention rates (100%) met the predetermined feasibility criteria. Eleven adverse events were reported but were supposedly unrelated to the intervention. In the intention‐to‐treat analysis, there was no clinically significant difference in the change in SPPB score between groups (−0.4 points, 95% confidence interval [CI], −1.2, 0.3); however, the intervention group scored higher in the mental component of HR‐QoL than did the control group (3.4 points, 95% CI: −1.1, 7.8).ConclusionsThe preliminary data indicate that a phase III trial is feasible, focusing on the mental aspect of HR‐QoL as the primary outcome. Geriatr Gerontol Int 2023; 23: 32–37.

Background: The influence of neurological or balance dysfunction on cognitive impairment has not been well studied. We compared the results of the balance test, measured by either head or foot sway to consider whole body sway, with those of the cognitive impairment test. Methods: Individuals of either gender, aged over 60 years, underwent a 30 s balance test. We measured sway while standing on one-leg or two-legs. Sway was evaluated by the distance or area of movement of the head or foot pressure. We also evaluated the effect of visual condition: eyes-open (EO) or -closed (EC). The Mini-Mental State Examination (MMSE) was used to evaluate the degree of cognitive impairment. Results: The head sway area standing on one leg was significantly correlated to MMSE score with EO (correlation r = −0.462). In standing on two legs, no sway test results showed a significant correlation to MMSE scores with EO. With EC, the magnitude of sway became greater, and was significantly correlated to MMSE scores in the head distance. Conclusion: Although the correlation between head sway and MMSE was not strong, head sway showed a stronger correlation than did foot pressure sway. Standing on one leg, as measured by head sway area, may thus predict cognitive impairment.

Urinary incontinence (UI) among older people is a common problem. Several treatments are available for older people with UI including surgery, drug therapies, and behavioral interventions. Recently, much attention has been placed on the behavioral treatments for UI, including pelvic floor muscle (PFM) exercise, weight loss exercise, and thermal therapy, as they have few risks, no side effects, and are effective. These therapies are often recommended as first line treatments for older people with UI. PFM exercise programs often incorporate alternations of fast contractions that are usually held for about two to three seconds interspersed with relaxation intervals of four to five seconds, and sustained contractions, where participants hold the contraction for about eight to ten seconds followed by a relaxation interval of ten to twelve seconds between the contractions. While exercise periods vary between 3 to 24 weeks, 8 to 12 weeks seems to be the most effective length for PFM exercise. The effectiveness of PFM exercise for the improvement of UI has been validated by many studies, with improvement rates ranging widely from 17 to 84%. Also, research has shown that UI is associated with obesity. Increases in body weight cause increases in abdominal wall weight, which in turn increases intra-abdominal pressure and intra-vesicular pressure. Therefore, abdominal fat reduction from exercise may decrease intra-abdominal pressure, perhaps causing improvements in urethral sphincter contraction and, hence, decreasing UI risk. Evidence reveals that PFM exercise and fitness training targeted at reducing modifiable risk factors are effective strategies for treating UI in older people, regardless of UI type.

Geriatric depression is a crucial public health concern. Cardiorespiratory fitness protects from the development of geriatric depression. However, the potential benefit of maintaining muscular fitness for preventing depressive symptoms remains unclear. PURPOSE: To prospectively investigate the relationship between knee extensor muscle strength and depressive symptoms in older women. METHODS: We conducted a 2-year cohort study of older Japanese women living independently in Itabashi, Tokyo, recruited through the Basic Resident Register. They underwent a baseline comprehensive geriatric examination, evaluating isometric knee extensor muscle strength (newtons/kilogram of body weight) and depressive symptoms (assessed by 15-item Geriatric Depression Scale [GDS]) via an interview-based questionnaire in 2017 or 2018. Their age, body mass index, smoking and alcohol consumption habits, comorbidities, working statuses, hobbies, volunteer activities, sleep durations, years of education, and dietary patterns were assessed as covariates. Participants free of stroke, dementia, or depression, were followed up. The onset of depressive symptoms was defined as a GDS score ≥ 5 points at follow-up. A logistic regression model was established by adjusting the baseline GDS score and the covariates. We performed a sensitivity analysis with the GDS cutoff of ≥6 points as an outcome variable. RESULTS: We recruited 1365 women in 2017 and 2018, and 1087 were eligible for this analysis. In 2019 and 2020, 642 women (mean age 71.4 years [standard deviation: 4.1]) provided valid data. Of them, 72 women (11.2%) developed depressive symptoms. After adjusting for the covariates, the odds ratio (95% confidence interval) of depressive symptoms was 0.69 (0.35, 1.33) for the middle tertile and 0.49 (0.23, 1.00) for the highest muscle strength tertiles using the lowest tertile as reference (p for trend = 0.006). The sensitivity analysis also supports a linear association between muscle strength and depression (p for trend = 0.02). CONCLUSIONS: This study suggests an inverse dose-response relationship between muscle strength and the onset of depressive symptoms in older Japanese women. It may be required to test whether muscle-strengthening training is beneficial in alleviating depressive symptoms in older women.

Aim Community settings often need simple screening, rather than detailed tests, to identify cognitive impairment. This study aimed to develop models to screen older adults with cognitive impairment. Methods This study used data from the Integrated Research Initiative for Living Well with Dementia Cohort Study and included 5830 older adults. Individuals were considered cognitively impaired if their Mini-Mental State Examination score was less than 24. Three screening models were developed: the simple model (age, sex, and education), the base model comprising 13 candidate variables available in the questionnaire, and the enhanced model, where grip strength and gait speed were added to the base model. We performed binary logistic regression analysis with stepwise backward elimination (P < 0.1 for retention in the model) to develop each model. Then, we calculated integer scores from coefficients to develop score-based models. The area under the receiver operating characteristic curve (AUC) was used to evaluate discrimination. Results Participants with cognitive impairment accounted for 4.0% (n = 233) of the total. The score-based simple model comprised three variables (AUC = 0.72, sensitivity: 72%, specificity: 61%). The score-based base model included nine variables (AUC = 0.76, sensitivity: 70%, specificity: 67%). The score-based enhanced model comprised eight variables, including grip strength and gait speed (AUC = 0.79, sensitivity: 73%, specificity: 70%). Conclusions This study developed three screening models with acceptable discriminant validity for cognitive impairment. These models comprised simple questionnaire-based items and common physical performance measurements. These models could enable screening of older adults suspected of cognitive impairment without the need to conduct cognitive tests in community settings. Geriatr Gerontol Int 2022; center dot center dot: center dot center dot-center dot center dot.

One prominent factor associated with malnutrition is poor appetite. In Japan, the number of older adults living alone has increased annually. Those living alone tended to eat alone, which may lead to poor appetite. This study aimed to investigate the association between eating alone and poor appetite using an index called the Simplified Nutritional Appetite Questionnaire (SNAQ). We surveyed 818 people aged 70 and over in Takashimadaira, Itabashi-ku, Tokyo, Japan, in 2016. Comparisons were made between two groups, a poor appetite group (n = 295) and a good appetite group (n = 523), and results indicate that the poor appetite group had a higher rate of eating alone than the good appetite group (38.0% vs. 20. 1%: p < 0.001). Multivariable logistic regression (OR; 95%CI) was performed and poor appetite was significantly associated with the Geriatric Depression Scale (GDS) score (1.707; 1.200-2.427), the number of medications (1.061; 1.007-1.118), JST score (0.894; 0.841-0.950), the indication of "very healthy" on a self-rated health scale (0.343; 0.152-0.774), and reports of eating alone (1.751; 1.130-2.712). Our results suggest that eating alone is associated with a poor appetite.

Neurodegenerative changes in the preclinical stage of Alzheimer’s disease (AD) have recently been the focus of attention because they may present a range of treatment opportunities. A total of 134 elderly volunteers who lived in a local community were investigated and grouped into preclinical and mild cognitive impairment stages according to the Clinical Dementia Rating test; we also estimated amyloid deposition in the brain using positron emission tomography (PET). A significant interaction between clinical stage and amyloid PET positivity on cerebral atrophy was observed in the bilateral parietal lobe, parahippocampal gyri, hippocampus, fusiform gyrus, and right superior and middle temporal gyri, as previously reported. Early AD-specific voxel of interest (VOI) analysis was also applied and averaged Z-scores in the right, left, bilateral, and right minus left medial temporal early AD specific area were computed. We defined these averaged Z-scores in the right, left, bilateral, and right minus left early AD specific VOI in medial temporal area as R-MedT-Atrophy-score, L-MedT-Atrophy-score, Bil-MedT-Atrophy-score, and R_L-MedT-Atrophy-score, respectively. It revealed that the R_L-MedT-Atrophy-scores were significantly larger in the amyloid-positive than in the amyloid-negative cognitively normal (CN) elderly group, that is, the right medial temporal areas were smaller than left in amyloid positive CN group and these left-right differences were significantly larger in amyloid positive than amyloid negative CN elderly group. The L-MedT-Atrophy-score was slightly larger ( p = 0.073), that is, the left medial temporal area was smaller in the amyloid-negative CN group than in the amyloid-positive CN group. Conclusively, the left medial temporal area could be larger in CN participants with amyloid deposition than in those without amyloid deposition. The area under the receiver operating characteristic curve for differentiating amyloid positivity among CN participants using the R_L-MedT-Atrophy-scores was 0.73; the sensitivity and specificity were 0.828 and 0.606, respectively. Although not significant, a negative correlation was observed between the composite cerebral standardized uptake value ratio in amyloid PET images and L-MedT-Atrophy-score in CN group. The left medial temporal volume might become enlarged because of compensatory effects against AD pathology occurring at the beginning of the amyloid deposition.