My 60-year-old father underwent a brain MRI. Everything was normal. However, the report included the following statement: "Involutional brain changes in the form of deepening of the cortical sulci with dilatation of the surrounding subarachnoid spaces." What does this mean?


The statement from the MRI report describes subtle changes in the structure of your father's brain. Many people experience such mild changes in the structure of their brain as they age.

To understand these changes, start with the largest part of the brain called the cerebral cortex. The cerebral cortex contains a large number of folds. Picture a rounded surface covered in deep meandering ridges and grooves. The spaces in between the folds of brain tissue are called the cortical sulci (pronounced sul-sye). As some people age, the folded brain tissue starts to shrink, making the spaces between the folds (the sulci) deeper and wider. These are called involutional brain changes.

In many people with dementia, the folds are greatly shrunken. The involutional changes described in your father's report are milder.

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What do your father's involutional brain changes mean? Scientists don't know for certain. They may indicate a greater risk for developing dementia. However, scientists debate this point. People with milder involutional brain changes like your father frequently have normal intellects and do not develop dementia.

What should your father do as a result of this report? He should do what all of us should do to help decrease our risk of developing dementia. It starts with following his doctor's instructions and taking medications regularly if he has a health condition that could affect his brain, such as high blood pressure, high cholesterol, diabetes, past strokes or mini-strokes, or coronary artery disease.

Regularly challenging your brain with new activities will help protect against loss of brain function. Also, exercising regularly will not only strengthen your muscles, improve conditioning, and protect your heart: It will also help protect you from developing dementia.