Hippocampal atrophy, typically measured using volumetry, is a hallmark feature of both normal aging and Alzheimer’s disease (AD). However,
… (see more) the earliest stages of atrophy manifest as microstructural changes in tissue composition rather than macroscopic volume loss. We conducted longitudinal in vivo mapping of hippocampal microstructure in healthy aging and incipient AD, highlighting demyelination, iron deposition, and changes in water content as markers of age and AD risk. A combination of macrostructural and microstructural measures provides a more comprehensive picture of brain health and disease, unlocking unique insights into the pathological state of brain tissue and the impact of AD at a point where therapeutic rescue of the tissue is most likely to be efficacious.