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We evaluated whether occurrence of posterior atrophy (PA) and medial temporal lobe atrophy (MTA) could account for differences in cognitive domains affected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In 329 patients with AD, we assessed five cognitive domains: memory, language, visuospatial functioning, executive functioning, and attention. Magnetic resonance imaging (MRI) was rated visually for the presence of MTA and PA. Two\u2010way analyses of variance were performed with MTA and PA as independent variables, and cognitive domains as dependent variables. Gender, age, and education were covariates. As PA is often encountered in younger patients, analyses were repeated after stratification for age of onset (early onset, \u2264 65 years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the participants was 67 years, 175 (53%) were female, and the mean Mini\u2010Mental State Examination (score \u00b1 standard deviation) was 20\u00a0\u00b1\u00a05 points. Based on dichotomized magnetic resonance imaging ratings, 84 patients (26%) had MTA and PA, 98 (30%) had MTA, 57 (17%) had PA, and 90 (27%) had neither. MTA was associated with worse performance on memory, language, and attention (all, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05), and PA was associated with worse performance on visuospatial and executive functioning (both, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). Stratification for age showed in patients with late\u2010onset AD (n\u00a0=\u00a0173) associations between MTA and impairment on memory, language, visuospatial functioning, and attention (all, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05); in early\u2010onset AD (n\u00a0=\u00a0156), patients with PA tended to perform worse on visuospatial functioning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Regional atrophy is related to impairment in specific cognitive domains in AD. The prevalence of PA in a large set of patients with AD and its association with cognitive functioning provides support for the usefulness of this visual rating scale in the diagnostic evaluation of AD.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.jalz.2013.06.007","type":"journal-article","created":{"date-parts":[[2013,11,6]],"date-time":"2013-11-06T20:00:52Z","timestamp":1383768052000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Regional atrophy is associated with impairment in distinct cognitive domains in Alzheimer's disease"],"prefix":"10.1002","volume":"10","author":[{"given":"Lieke L.","family":"Smits","sequence":"first","affiliation":[{"name":"Alzheimer Center and Department of Neurology VU University Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betty M.","family":"Tijms","sequence":"additional","affiliation":[{"name":"Alzheimer Center and Department of Neurology VU University Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marije R.","family":"Benedictus","sequence":"additional","affiliation":[{"name":"Alzheimer Center and Department of Neurology VU University Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther L.G. 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