Which statement about white matter abnormalities and aging is true?

• A. White matter abnormalities never seen in healthy elderly
• B. White matter abnormalities are always present in healthy elderly
• C. White matter abnormalities can be seen in healthy elderly without cognitive decline
• D. White matter abnormalities only occur with vascular disease

Answer: (C)

White matter changes increase with age and are commonly seen on brain imaging in people who are otherwise cognitively normal. These white matter abnormalities, often called white matter hyperintensities, reflect chronic microvascular and myelin-related changes that accumulate over time. They are more frequent with vascular risk factors such as high blood pressure, but their presence does not by itself indicate cognitive decline. In many healthy older adults, these changes coexist with normal cognitive function, though a heavier burden can be associated with slower processing speed or executive difficulties.

So, the true statement is that white matter abnormalities can be seen in healthy elderly without cognitive decline. They are not never present in healthy elderly, nor always present, and they are not exclusive to vascular disease—aging itself can produce these changes, with vascular risk factors influencing their extent.