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Although \u03b2\u2010amyloid deposition is widely regarded as the principal neuropathological hallmark of Alzheimer's disease, its precise role in the causal chain of cognitive decline remains under debate. Applying strict criteria to define neurocognitive health, a selection of 35 participants aged over 60\u2009years was drawn from the Human Connectome Project\u2014Ageing. The evaluation of both cognitive and physical fitness, and comprehensive magnetic resonance imaging (MRI) protocol, encompassing diffusion\u2010weighted imaging, T1w\/T2w ratio, resting\u2010state functional MRI and arterial spin labelling, were combined with an additional 18F\u2010florbetaben scan to evaluate \u03b2\u2010amyloid load. Strikingly, \u03b2\u2010amyloid load failed to adhere to the transcription patterns of amyloid precursor protein in all surveyed areas but the entorhinal cortex. Moreover, it was associated with either higher cognitive performance, general fitness, cerebral tissue integrity and cerebral perfusion, or had no discernible impact. This pilot study adds to the growing body of evidence that questions the significance attributed to \u03b2\u2010amyloid build\u2010up and the mechanisms of its accumulation in the ageing brain. The results invite a re\u2010evaluation of established theories on \u03b2\u2010amyloid build\u2010up neurotoxicity at low concentrations as observed in this cohort. Future investigations should focus on recruiting larger populations to ascertain whether a specific threshold of \u03b2\u2010amyloid build\u2010up precipitates cognitive decline or whether \u03b2\u2010amyloid accumulation, in fact, serves as a protective mechanism that ultimately fails.<\/jats:p>\n                  <jats:p>\n                    <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                      <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/jnc70241-gra-0001-m.png\">\n                        <jats:alt-text>image<\/jats:alt-text>\n                      <\/jats:graphic>\n                    <\/jats:boxed-text>\n                  <\/jats:p>","DOI":"10.1111\/jnc.70241","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T07:27:37Z","timestamp":1758612457000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and\n                    <scp>MRI<\/scp>\n                    Correlates of \u03b2\u2010Amyloid Load Inconsistent With Its Presumed Neurotoxicity in Cognitively Healthy Ageing"],"prefix":"10.1111","volume":"169","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5656-5164","authenticated-orcid":false,"given":"Pavel","family":"Filip","sequence":"first","affiliation":[{"name":"Center for Magnetic Resonance Research (CMRR) University of Minnesota  Minneapolis Minnesota USA"},{"name":"Department of Neurology Charles University, First Faculty of Medicine and General University Hospital  Prague Czech Republic"},{"name":"Department of Cybernetics Czech Technical University in Prague  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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